Clinical Study Of Improved DP Regimen As First-line Therapy For Advanced NSCLC

Background and Objective:Docetaxel combined with cisplatin is established as first-line therapy for advanced non-small cell lung cancer(NSCLC). Retrospective analysis was performed to evaluated the short-term efficacy and toxicity of the regimen in which docetaxel administered on days 1,8 plus cisplatin on days 2-6 every 4 weeks in previously untreated patients with advanced non-small cell lung cancer (NSCLC).Methods:41 patients with advanced NSCLC confirmed by pathology or cytology who were admitted into the department of oncology at The Third Xiangya Hospital of Central South University from August 2003 to June 2009 were enrolled.3 of them had stageⅢa disease,20 and 18 had stagesⅢb and IV disease respectively; all patients had measurable disease, no prior chemotherapy, and Karnofsky scale≥60. Docetaxel was administered at a dose of 40mg/m2 through intravenous infusion on days 1,8 and cisplatin was administered at a dose of 20mg/m2 on days 2-6. The chemotherapy was repeated every 4 weeks. Patients were evaluated for response after every 2 cycles of treatment.Results:A total of 142 cycles of chemotherapy were administered. Of the 41 patients,17 achieved partial response,15 showed stable disease, and 9 had progressive disease. The overall response rate(ORR) was 41.5%. The median time to disease progression was 5.6 months (3.0-19.1months). The major hematologic toxicity was myelosuppression. Grade 3-4 leukopenia was observed in 3 patients(7.3%), and grade 3-4 anemia occurred in 4 patients(9.8%). Major non-hematologic toxicities were as follows:grade 3 nausea and vomiting occurred in one patient(2.4%), grade 3 constipation in two patients(4.9%), grade 3 fatigue in two patients(4.9%) and grade 3 alopecia in one patient(2.4%). No treatment-related deaths occurred in this study.Conclusion:The regimen of docetaxel administered on days 1,8 combined with cisplatin on days 2-6 as first-line therapy for advanced NSCLC showed favorable overall response rate and time to disease progression, and its toxicity was slight and well tolerated.Further randomized studies are needed.