Clinical Observation And Quality Of Life Analysis Of Low-dose Gemcitabine Infusion In Non-small-cell Lung Cancer

Objective: 1. To evaluate and compare the efficacy and toxicity in advanced non-small-cell lung cancer (NSCLC) patients treated by different GP regimens: gemcitabine at a low dose of 250mg/m2 in 6h prolonged infusion with cisplatin regimen (L-GP) and normal dosage Gemcitabine infusion with cisplatin regimen (GP). 2. To evaluate the effect on quality of life (QoL) of two regimens. 3. To explore the relationship between efficacy and response of QoL .Method: 1. 67 patients with stageâ…¢b orâ…£NSCLC were randomly divided into two groups,of 64 patients with evaluable lesions,which receive either L-GP regimen( 32 cases) or GP regimen (32 cases) respectively. The response rate and toxicity were compared in two groups of patients. 2. EORTC QLQ-C30 and QLQ-LC13 questionnaires (Chinese edition) were filled in and KPS were detected before and after 2 cycles of chemotherapy to evaluate the effect on QoL of two regimens.Results: 1. Efficacy and toxicity of two groups:â‘ The response rate of L-GP group was 37.5%, and GP group was 34.4% (P>0.05).â‘¡Median time to progression were 7.0 months and 7.2 months (P>0.05) in L-GP group and GP group, and 1-year survival rate were 30% and 34% respectively (P>0.05).â‘¢Toxicity : L-GP group was associated with less grade 3-4 neutropenia and thrombocytopenia than GP group(P<0.05). Haematoglobin drease didn't show statistical difference in two groups. There was no statistically difference in nonhematologic toxicity between two groups. 2. Evaluation and comparison of quality of life:â‘ The increase rate of KPS were high up to 71.9% and 75.0% in L-GP group and GP group respectively (P>0.05).â‘¡Mean scores of five functional status (physical functioning, role functioning, cognitive functioning, emotional functioning and social functioning) and global QoL increased in two groups after chemotherapy,scores improved showed statistical difference (P<0.05). while mean scores of two general symptoms (fatigue and appetite loss) and disease associated symptoms (dyspnoea, coughing, haemoptysis, pain in chest, pain in arm or shoulder and pain in other location) decreased,scores decreased showed statistical difference (P<0.05). The response rate of QoL in two groups showed no significantly statistical difference.â‘¢The response rate of global QoL, physical functioning, role functioning, fatigue, appetite loss, dyspnoea and coughing were associated with efficacy (P<0.05), while the response rate of emotional functioning, cognitive functioning, social functioning and pain in chest didn't correlate with the efficacy (P>0.05).Conclusions: 1. Compared with normal dosage infusion GP regimen, prolonged infusion of low-dose GP regimen had less grade 3 and 4 thrombocytopenia and neutropenia toxicity, but prostecdtive efficacy showed no statistical difference. 2. KPS reflected response to treatment and response rate of QoL in a certain degree. The higher the KPS before chemotherapy, the higher the response rate of chemotherapy. 3. Both regimens could improve the QoL of most patients with advanced NSCLC and the response rate was similar.