Göðüs Hastanesi Dergisi. 2002; 16(1): 13-14

ÝLERÝ EVRE KÜÇÜK HÜCRELÝ DIÞI AKCÝÐER KANSERÝNDE SÝSPLATÝNETOPOSÝD TEDAVÝSÝNÝN ETKÝNLÝÐÝ

Zeynep Zeren UÇAR¹, Nimet AKSEL¹, Aydan ÇAKAN¹, Ayþe ÖZSÖZ¹
Dr. Suat Seren Ýzmir Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý ve Tüberküloz Kliniði, ÝZMÝR

Ýleri evre küçük hücreli dýþý akciðer kanserinde kemoterapinin yeri uzun yýllardýr tartýþma konusudur. Bu çalýþmada sisplatin-etoposid tedavi rejiminin etkinliðinin semptomatik tedavi ile saðkalýma etkisi açýsýndan karþýlaþtýrýlmasý amaçlanmýþtýr. Ocak 1997-Mart 2001 arasýnda kliniðimizde evre IIIB ve IV küçük hücreli dýþý akciðer kanseri tanýsý almýþ 60 olgu çalýþmaya alýndý. Otuz olguya kemoterapi, 30 olguya semptomatik tedavi uygulandý. Kemoterapi alan olgulara üç hafta aralarla maksimum altý siklus olacak þekilde ilk gün 80 mg/m2 sisplatin ve ilk baþlanacak üç gün sürecek þekilde günde 100 mg/m2 etoposide IV uygulandý. Saðkalým analizleri ‘Kaplan-Meier Product-Limit' yöntemiyle hesaplandý. Evre IIIB'de kemoterapi alan 20 olguda medyan saðkalým süresi 13.9 ay, bir yýllýk saðkalým oraný % 60, semptomatik tedavi alan 22 olguda ise 6.3 ay ve % 18 bulundu. Evre IV'te ise, kemoterapi alan 10 olguda medyan saðkalým süresi 9.4 ay ve bir yýllýk saðkalým oraný % 40, semptomatik tedavi alan 8 olguda ise 3.7 ay ve %25 bulundu. Semptomatik tedavi ve kemoterapi gruplarýnýn medyan saðkalým süreleri ve bir yýllýk saðkalým oranlarý arasýndaki fark evre IIIB olgularýnda kemoterapi lehine istatistiksel olarak anlamlý bulundu (p<0.0003, p<0.005). Evre IV'te ise fark anlamlý deðildi. Kemoterapiye yanýt %26 kýsmi, %3.3 tam yanýt þeklindeydi. Toplam yanýt oraný %29.3 idi. Toplam yan etki görülme oraný % 63.3 idi (5 olguda grade 3, 1 olguda grade 4). Sonuç olarak; ileri evre küçük hücreli dýþý akciðer kanserinde sisplatinetoposid kemoterapisinin etkin bir tedavi yöntemi olduðu ve hala tercih edilebileceði, bu etkinliðin evre IV' ten çok evre IIIB' de daha belirgin olduðu sonucuna vardýk.

Anahtar Kelimeler: Küçük hücreli dýþý akciðer kanseri, kemoterapi, sisplatin, etoposid

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EFFICACY OF CISPLATIN-ETOPOSIDE CHEMOTHERAPY IN ADVANCED NON-SMALL CELL LUNG CANCER

Zeynep Zeren UÇAR¹, Nimet AKSEL¹, Aydan ÇAKAN¹, Ayþe ÖZSÖZ¹
Dr. Suat Seren Ýzmir Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý ve Tüberküloz Kliniði, ÝZMÝR

The role of chemotherapy in the treatment of non-small cell lung cancer has been a matter of concern for many years. This study aims to compare cisplatinetoposide combined treatment modality with supportive treatment according to their effects on survival. Between 1997-2001, 60 patients, who were diagnosed as having stage IIIB and IV non-small cell lung cancer in our clinic, were included in the study. Following all necessary clinical staging procedures, 30 cases received chemotherapy, while remaining 30 cases were treated symptomatically. Chemotherapy protochol included cisplatin with a dose of 80 mg/m2/day intravenously administered on the first day and etoposide with a dose of 100 mg/m2/day starting the first day, continuing for three days in three weeks intervals for a maximum of six cycles. “Kaplan-Meier Product- Limit” method was utilized for survival analysis. In stage IIIB; 20 cases, who received chemotherapy, had a median survival as 13.9 months and one year survival rate as 60 %. 22 cases, who were treated symptomatically, had a median survival as 6.3 months and one year survival rate as 18 %. In stage IV; 10 cases, who received chemotherapy, had a median survival, as 9.4 months and one year survival rate as 40 %. 8 cases, who were treated symptomatically, had a median survival as 3.7 months and one year survival rate as 25 %. The difference of median survivals and one year survival rates between chemotherapy group and symptomatic group were istatistically significant for chemotherapy group in stage IIIB ( p<0.0003, p<0.005) while the difference wasn't significant in stage IV. Partial and complete response rates were 26 % and 3.3 % respectively, with a total response rate of 29.3 %. Chemotherapy related side effects were encountered in 63.3 % of the cases (grade 3 side effect in 5 cases, grade 4 side effect in one case). In conclusion; we have suggested that chemotherapy with cisplatin-etoposide is an effective treatment method in management of advanced stage non-small cell lung cancer and can still be preferred, and this effect is more appaerent in stage IIIB disease than stage IV disease. The role of chemotherapy in the treatment of non-small cell lung cancer has been a matter of concern for many years. This study aims to compare cisplatinetoposide combined treatment modality with supportive treatment according to their effects on survival. Between 1997-2001, 60 patients, who were diagnosed as having stage IIIB and IV non-small cell lung cancer in our clinic, were included in the study. Following all necessary clinical staging procedures, 30 cases received chemotherapy, while remaining 30 cases were treated symptomatically. Chemotherapy protochol included cisplatin with a dose of 80 mg/m2/day intravenously administered on the first day and etoposide with a dose of 100 mg/m2/day starting the first day, continuing for three days in three weeks intervals for a maximum of six cycles. “Kaplan-Meier Product- Limit” method was utilized for survival analysis. In stage IIIB; 20 cases, who received chemotherapy, had a median survival as 13.9 months and one year survival rate as 60 %. 22 cases, who were treated symptomatically, had a median survival as 6.3 months and one year survival rate as 18 %. In stage IV; 10 cases, who received chemotherapy, had a median survival, as 9.4 months and one year survival rate as 40 %. 8 cases, who were treated symptomatically, had a median survival as 3.7 months and one year survival rate as 25 %. The difference of median survivals and one year survival rates between chemotherapy group and symptomatic group were istatistically significant for chemotherapy group in stage IIIB ( p<0.0003, p<0.005) while the difference wasn't significant in stage IV. Partial and complete response rates were 26 % and 3.3 % respectively, with a total response rate of 29.3 %. Chemotherapy related side effects were encountered in 63.3 % of the cases (grade 3 side effect in 5 cases, grade 4 side effect in one case). In conclusion; we have suggested that chemotherapy with cisplatin-etoposide is an effective treatment method in management of advanced stage non-small cell lung cancer and can still be preferred, and this effect is more appaerent in stage IIIB disease than stage IV disease.

Keywords: Non-small cell lung cancer, chemotherapy, cisplatin, etoposide

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ATIF KOPYALA