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Comparison of cisplatin- and carboplatin-based third-generation chemotherapy in 1,014 Chinese patients with advanced non-small-cell lung cancer

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Abstract

The outcome of patients with stage IIIB/IV non-small-cell lung cancer treated with platinum-based chemotherapy as first-line therapy was investigated to determine if cisplatin- or carboplatin-based combination therapy have similar efficacy by comparing the overall survival and safety profile for each combination regimen. A total of 1,014 patients, treated for stage IIIB and IV NSCLC between January 2002 and December 2008, with initial ECOG performance status of 0 and 1, adequate hematologic, hepatic, and renal function, who received at least two cycles of third-generation platinum-based chemotherapy, survived greater than 90 days, and experienced death were included for survival and safety analysis. Of them, 788 patients received cisplatin-based chemotherapy and 226 carboplatin-based. Cisplatin-based regimen yield significant better overall survival with a median survival time of 324 days compared to that of the carboplatin-based regimen of 286 days, attributable to the survival benefit of patients with stage III B (379 days vs. 283 days, Log-rank P = 0.003), or with histology of squamous (308 days vs. 262 days, Log-rank P = 0.01). Patients of the carboplatin-based arm were more likely to experience thrombocytopenia (OR = 0.560, 95% CI = 0.332–0.944, P = 0.028), while cisplatin-based chemotherapy was associated with more nausea and vomiting (OR = 3.720, 95% CI = 1.971–7.021, P < 0.0001). Non-small-cell lung cancer patients with stage IIIB disease and good performance status have a better survival advantage when treated with third-generation cisplatin-based chemotherapy compared to carboplatin-based regimen, and patients with squamous histology type may have experienced greater survival benefit than those with adenocarcinoma.

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Acknowledgments

We would like to thank Caifen Wu, RN, for her enormous effort in follow-up with all the patients listed in the registry. This work was supported by Shanghai Municipal Natural Science Foundation 10ZR1424900.

Conflict of interest statement

All authors have no conflicts of interest.

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Authors and Affiliations

  1. Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, 200433, Shanghai, China

    Jie Luo, Ying Xu & Di Zheng

  2. Department of Medical Oncology, Fudan University Shanghai Cancer Center, 270 Dongan Road, 200032, Shanghai, China

    Shiang J. Leaw

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  1. Jie Luo
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  2. Shiang J. Leaw
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  3. Ying Xu
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  4. Di Zheng
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Correspondence to Di Zheng.

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Luo, J., Leaw, S.J., Xu, Y. et al. Comparison of cisplatin- and carboplatin-based third-generation chemotherapy in 1,014 Chinese patients with advanced non-small-cell lung cancer. Med Oncol 28, 1418–1424 (2011). https://doi.org/10.1007/s12032-010-9575-3

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  • DOI: https://doi.org/10.1007/s12032-010-9575-3

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