Efficacy and Toxicity Chemotherapy with Cisplatin + Etoposide Regiment in Advanced Stage Non-Small Cell Lung Cancer

· Thoracic Oncology

Syahruddin E, Marlina N, Hudoyo A. J Respir Indones. 2012;32(1):25-35.


Introduction: Standard chemotherapy for non-small cell lung cancer is platinum based regiment. Cisplatin is one the most potent anti-cancer agent that widely used for lung cancer. Meta-analysis results shows cisplatin has efficacy superior than carboplatin. In our experient, carboplatin based more often used in chemotherapy for non-small cell lung cancer. We performed a study to evaluate efficacy and toxicity of cisplatin+etoposide regiment in non-small cell lung cancer patients.
Methods: The study was a longitudinal observation in non small cell lung cancer patients. Patients were treated with cisplatin 60 mg/m2 day 1 and etoposide 100 mg/ m2 day 1-3 in .three weekly chemotherapy. Responses (subjective, semisubjective and objective) were evaluated in every cycle of chemotherapy. Objective Response evaluated with response evaluation criteria in solid tumor (RECIST) criteria. Toxicities (hematologic and non-hematologic) were evaluated every week after the first day chemotherapy based on WHO criteria.
Results: From 35 patients with non-small cell lung cancer were eligible according to inclusion criteria’s. There were 26 of 35 (74.3%) males and 9 of 35 (25.7%) female. Histologic type was 25 (71.4%) adenocarcinomas, 8 (22.8%) squamous cell carcinoma, and 2 (5.8%) large cell carcinoma. All of patient with advanced stage, there were 9 (25.7%) patients with stage IIIB, and 26 (74.3%) patients with stage IV. An average chemotherapy cycle was 4 cycles (range 2– 6 cycle). We found no one patients had complete response, 3 of 35 (8.6%) had partial response, 25 of 35 (71.4%) had stable diseases, 7 of 35 (20%) had progressive response. Bodyweight of all patients were decreased during chemotherapy. On other side, 6 of 35 (17.1%) patients were decreased symptoms. The median survival time was 121 days (+/- 4 months) and 1-year survival rate was 5.2%. Data showed rare severe hematologic toxicities, such as anemia grade 3 were 3 of 35 (2.9%). leucopenia grade 3 were 2 of 35 (5.7%) among the patients. The same condition have found in non-hematologic toxicity
Conclusion: Although, used cisplatin+etoposide regiment had tolerable toxicities but response were low. For that reason should be re-evaluated to use cisplatin+etoposide regiment as first line chemotherapy in advanced stage nonsmall lung cancer.

Keywords: Cisplatin, etoposide, non-small cell lung cancer, efficacy, toxicity

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