Clinical Research Of S-1in The Maintenance Treatment For Patients With Advanced Non-small Cell Lung Cancer

Background and objectivesIn the current,lung cancer is the first tumor factors of the threat to the humansurvival, non-small cell lung cancer (NSCLC) accounts for about80percentage ofthe total number of lung cancer,most diagnosis of the NSCLC has been closed tostage III/IV, surgical treatment is not always a best treatment,So for the patients,thepreferred treatment is comprehensive treatment based on systemic chemotherapy,andchoose low toxicity, high efficiency of chemotherapy drugs as far as possible.Thishas been widely used in a large number of clinical trials.For patients with advanced,whether can we find a treatment to further control tumor, improve life quality,prolong survival,the answer is yes.Current maintenance therapy is becoming a hotspot in the research of the lungcancer, a large number of phase I, II and III clinical trials show that, to gastric cancer,colon cancer, rectal cancer, pancreatic cancer, breast cancer, cervical cancer andother solid tumors, including lung cancer, either single drug or joint, S-1has thequite obvious inhibition;Approed for sale in Japan in1999for the first time, thebrand name is TS-1;For gonow joint platinum first-line treatment of advancednon-small cell lung cancer is effective and its toxicity to mild reaction, quality of lifeis improved obviously, the drug has been approved in Japan in2004, as standardchemotherapy for advanced non-small cell lung cancer, a lot of related research is also done homeland.This study intends to investigate the efficiency and its safety ofS-1and docetaxel in the maintenance treatment for advanced non-small cell lungcancer,to evaluate its clinical efficiency and tolerability,count disease controlrates,total effective ratesof two groups, progression-free survival and overallsurvival, to provide new ideas and methods for the clinical treatment of advancednon-small cell lung cancer.MethodsOne-hundred patients who were conformed by pathological histology orimaging with a diagnoses of IIIB/IV stage from Auguest1,2010-August1,2012,the first affiliated hospital of zhengzhou university.Karnofsky performance status≧60points, Group (ECOG) performance status (PS) of0or1or2,the male isfifty-six,female is fortyty-four, aged20to78years old,the median age is52.5years,forty-eight cases is adenocarcinoma, squamous carcinoma is fifty-twocases,who have accepted standard first-line chemotherapy (paclitaxel plus platinum,gemcitabine combined cisplatin, vinorelbine etc.) four cycles and disease isprogression-free, randomly divided into two groups,according to1:1proportion:S-1group, docetaxel group, fifty cases in each.This study intends to investigate theefficiency and its safety of S-1and docetaxel in the maintenance treatment foradvanced non-small cell lung cancer,to evaluate its clinical efficiency andtolerability,count disease control rates,total effective rates of two groups, medianprogression-free survival and median survival time.Resultsone-hundred patients all accept four cycle maintenance treatment,all patientscan evaluate the efficacy. S-1group:complete response (CR) is two patients, partialresponse (PR) is twenty-nine, stable disease is (SD) eight, progressive disease (PD)iseleven; docetaxel group:complete response (CR) is one patients, partial response (PR)is twenty-seven, stable disease is (SD) nine, progressive disease (PD)is thirteen. disease control rates (DCR): S-1group is78%(39/50),docetaxel group is74%(37/50);overall response of the two groups is62%(31/50),56%(28/50）respectively. compareefficacy between the twogroups, there is no statistically significant difference(X2=0.0635, X2=0.0851,P=0.4653,P=0.5219,P>0.05). Compare two groups’ qualityof the life, there is no statistically significant difference(P>0.05);compare side effectsbetween the two groups,the incidence of neutropenia, anemia, thrombocytopenia,nausea and vomiting, the differences are statistically significant.(X2=4.398、4.015、2.201、3.276，P=0.038、0.041、0.026、0.033).For other side effects, the incidenceo between the two groups are lower, the difference is not significant.As far asfollow-up deadline,S-1group’s medianPFS is6.9months，while docetaxel group is6.3months,there is no statistically significant difference（P>0.05）,S-1group’s mediansurvival time is12.1months，while group’s median survival time is10.3months,thereis no statistically significant difference（P>0.05）.Conclusion1. S-1used for the maintenance treatment of advanced non-small cell lungcancer,compared with the docetaxel group, the effect in curative effectevaluation and quality of life is quite equal, both can extendprogressionsive-free survival time and overall survival time.S-1used for the maintenance treatment of advanced non-small cell lungcancer, adverse reaction is slight, drug delivery way convenient, especially forolder patients, for the further treatment of non-small-cell lung cancer (NSCLC)provides a new train of thought and method, worthy of clinical research andextension on a large scale clinical.