Cisplatin Plus Docetaxel Combination In The First-line Treatment Of Advanced Non-small Cell Lung Cancer

Backgroud and objective:The platinum-based third-generation combined chemotherapy is the internationally recognized standard treatment for advanced NSCLC, docetaxel is FDA approved first-and second-line NSCLC treatment standards.Over the years, as the only second-line drug, docetaxel was often used in the advanced and retreatmented patients, but the retreatmented patients are often poor of PS scores,who can not tolerate chemotherapy and lost opportunities. With the emergence of molecular targeted drugs, more and more patients use the molecular targeted drugs as the second-line treatment.Better understanding of cisplatin plus docetaxel combination in the first-line treatment of advanced NSCLC, the efficacy and associated factors have the exact clinical significance.This study of cisplatin plus docetaxel combination in the first-line treatment of advanced NSCLC discusses the efficacy, progression-free survival, survival rate and its related factors and adverse conditions.Methods:33 patients were given docetaxel 75mg/m2adding saline injection 250ml, intravenous infusion, dl; cisplatin 75mg/m2 adding saline 500ml, dl～3,intravenous infusion every 3 weeks as a cycle, each complete evaluated after 2 cycles, disease progression and patients were followed up to death. Application of SPSS 16.0 software evaluation by Kaplan-Meire median survival and overall survival, the Log-rank non-parametric test. Patients with advanced NSCLC in 33 patients the efficacy and toxicity and survival.Results:All the 33 patients had complete follow-up data.The effective rate was 24.2%, the disease control rate was 60.6%,the median progression-free survival(PFS) of all the patients is 5.7 months, the median survival time(MST) of all the patients is 14.3 months, one-year survival rate was 63.6%. Univariate analysis showed that men and women, the median PFS was 5.3 months vs 6.2 months (P=0.537); the median OS was 13.8 months vs 15.9 months (P=0.390). PS score of 0 points,1 point and 2 points, median PFS was 6.2 months,6.3 months and 3.9 months (P=0.037); as of the date of follow-up PS score of 0 points, the median OS of patients does not appear, PS score was 1 point and 2 points in the median OS was 17.1 months vs 8.6 months (P=0.002). Aged < 65 years of age and older The median PFS was 6.2 months vs 2.5 months (P=0.031); the median OS was 15.9 months vs 6.9 months (P=0.029). Non-smoking and smoking patients with a median PFS was 5.3 months vs 6.1 months (P=0.529); the median OS was 17.1 months vs 13.8 months (P=0.338). Adenocarcinoma, squamous cell carcinoma and other types of patients the median PFS was 5.6 months,6.2 months and 6.3 months (P=0.793); as of the date of follow-up of patients with squamous cell carcinoma does not appear in the bit OS, adenocarcinoma and other types of median OS was 14.3 months vs 12.5 months (P=0.587).IIIB and IV median PFS was 7.4 months vs 5.3 months (P=0.500); as of the date of follow-up of patients IIIB does not appear in the bit OS, IV median OS was 14.3 months. Use of imported and domestic docetaxel in patients with a median PFS was 5.6 months vs 6.2 months (P=0.802), median OS was 17.1 months vs 13.7 months (P=0.365). Efficacy evaluation for the PR, SD, PD patients with a median PFS was 7.2 months,6.2 months and 2.7 months (P=0.002); patients at follow-up date does not appear in the PR-bit OS, SD and PD patients with a median OS was 15.9 months vs 10.3 months (P=0.081). Did not receive and accept the follow-up median PFS of patients treated was 5.6 months vs 5.7 months (P=0.118), as of the date of follow-up of patients receiving follow-up does not appear in the bit OS, patients did not receive follow-up median OS was 12.5 months.Conclusion:Docetaxel plus cisplatin is effective first-line treatment of advanced NSCLC with high response rate, longer PFS and OS, and the toxicity can be tolerated. Docetaxel combined with cisplatin had no obvious selectivity for a wide range on sex, smoking history, histological type, clinical stage. Older than 65 years of age and older patients with poor PS scores were treated with docetaxel and cisplatin regimen effective rate, overall survival is short, the high incidence of adverse reactions, such patients should be careful first-line use of the program. Docetaxel combined with cisplatin in the first-line treatment of advanced NSCLC was more effective compared with second-line, should be used as early as possible in the first-line.