Med Bull Sisli Etfal Hosp. 2003; 37(1): 23-25

Comparison of chemotherapy protocols in NSCLC

Ö. Maral, D. Karaçetin, B. Yücel, Ö. Aksakal, D. Özcan, Y. Baþer, O. Ýncekara
Þiþli Etfal Eðitim ve Araþtýrma Hastanesi, Radyasyon Onkolojisi Kliniði, Ýstanbul

Objective: In spite of surgery, chemotherapy and radiotherapy, median survival in NSCLC is about 8 to 10 months. Thus alternative regimens are heeing tried. In this study we aimed to evaluated different chemotherapy regimens to their effectivies and tolerability.
Study design: The years of 1996-1999, 235 NSCLC patients who we are treated and followed up more than 6 months in Sisli Etfal Hospital, Radiation Oncology clinic are evaluated.
Results: The patients are compared, for the time to progression, Survival and side effects. 62 patients were received ICE, 67 patients were received cisplatinum and etoposide, 98 patients were received cisplatinum+vinorelbine+gemcitabine and 8 patients were received oral etoposide in 6 cycles. Chemotherapy was given after surgery and/or radiotheray. The time during the followed up métastasés were seen; 13 patients in ICE arm, 15 patients in cisplatinum+etoposide arm and. 21 patients in cisplatinum+vinorelbine+gemcitabine arm. Exitus was seen 41 patients in ICE arm, 36 patients in Cisplatinum+etoposide arm, 64 patients in cisplatinum+vinorelhine+gemcitabine arm and 4 patients in oral etoposide arm. The time to progression was 4.5 months in ICE arm, 4.1 months in cisplatinum+etoposide arm, 4 months in cisplatinum+vinorelbine+gemcitabine arm. Median survival was 11.1 months in ICE are, 12.2 months in cisplatinum+etoposide arm, 13.6 months in cisplatinum+vinorelbine+gemcitabine arm. (p: 0.11) There was not seen any toxicides WHO grade 3-4. There was no any patients who died during the chemotherapy arm, 36 patients in ci.splat.inum+etoposide arm, 64 patients in cisplatinum+vinorelbine+gemcitabine arm and 4 patients in oral etoposide. The time to progression was 4.5 months in ICE arm, 4.1 months in cisp- latinum+etoposide arm, 4 months in cisplatinum+vinorelbine+gemcitabine arm. Median survival was 11.1 months in ICE are, 12.2 months in cisplatinum+etoposide arm, 13.6 months in cisplatinum+vinorelbine+gemcitahine arm. (p: O.llJThere was not seen any toxicides WHO grade 3-4. There was no any patients who died during the chemotherapy.

Keywords: Cisplatinum+vinorelbine+gemcitabine regimens is well tolerated. It has equavalent effectivines when compared the other standart regimens.

---

Nonsmall cell akciðer kanserinde kemoterapi protokollerinin etkinlik karþýlaþtýrmasý

Ö. Maral, D. Karaçetin, B. Yücel, Ö. Aksakal, D. Özcan, Y. Baþer, O. Ýncekara
Þiþli Etfal Eðitim ve Araþtýrma Hastanesi, Radyasyon Onkolojisi Kliniði, Ýstanbul

Amaç: NSCLC‘de cerrahi, RT ve KT’ye raðmen median sað- kalým siiresi 8 ile 10 ay arasýnda deðiþmektedir. Bu nedenle klasik kemoterapi rejimlerine alternatif rejimler denenmekte¬dir. Bu çalýþmamýzda Cisplatin+Etoposide; Cisplatin+Gem- citahin + Vinorelhine; Ifosfamide + Cisplatiýý + Etoposide kombinasyonlarýnýn etkinlik ve tolerabilite açýsýndan karþý¬laþtýrýlmasý amaçlandý.
Gereç ve Yöntem: ÞEH Radyasyon Onkolojisi Kliniðine NSCLC tanýsýyla baþvuran 800 hastadan 6 ay ve daha uzun süreli takibi yapýlan 235 hasta deðerlendirmeye alýndý, istatis¬tiksel anlamlýlýðý deðerlendirmede Ki-Kare testini kullandýk.
Bulgular: Hastalar progresyona dek geçen süre, toplam sað- kalým süresi ve yan etkileri yönünden karþýlaþtýrýldý. Kemote¬rapi toplam 6 kür yapýldý. 62 hastaya ÝCE, 67 hastaya Cispla¬tin+Etoposide, 98 hastaya Cisplatin+Vinorelbine+ Gemcita- bin, 8 hastaya oral etoposide uygulandý. Hastalara RT ve/ve¬ya cerrahi sonrasý kemoterapi uygulandý. Gruplar arasýnda yaþ, cinsiyet, uygulanan kür sayýsý, ve performans durumu açýsýndan anlamlý fark yoktu. Takip sýrasýnda ICE kolunda 13 hastada; Cisplatin+Etoposide kolunda 15 hastada; Cispla- tin+Gemcitabin+Vinorelbine kolunda 21 hastada metastaz gözlendi. ÝCE kolunda 41 hasta; Cisplatin+Etoposide kolun¬da 36 hasta; Cisplatin+Gemcitabin+Vinorelbine kolunda 64 hasta; oral Etoposide kolunda 4 hasta ex olmuþtur. Progres¬yona kadar geçen þiire ICE kolunda 4.5 ay; Cisplatin+Etopo¬side kolunda 4.1 ay; Cisplatin+Gemcitabin+Vinorelbine ko¬lunda 4 ay olarak bulunmuþtur. Ortalama saðkalým ICE ko¬lunda 11.1 ay; Cisplatin+Etoposide kolunda 12.2 ay; Cispla- tin+Gemcitabin + Vinorelhine kolunda 13.6 ay þeklidedir. Gruplar arasýnda progresyona kadar geçen þiire ve toplam yaþam süresi açýsýndan anlamlý bir fark yoktu (p: 0.11). Tok- sisite deðerlendirmesi WHO kriterlerine göre yapýldý. Her 3 gurupta da tedaviyi sonlandýrmayý gerektirecek düzeyde (WHO grade3-4) yan etki gözlenmedi. Kemoterapiye baðlý olarak ölen hasta olmadý.
Sonuç: NSCLC’li hastalarda 3’lü kombinasyonun standart kemoterapi rejimlerine eþit etkinlikte ve iyi. tolere edilebilen bir tedavi seçeneði olduðu görülmüþtür.

Anahtar Kelimeler: Cisplatinum+vinorelbine+gemcitabine regimens is well tolerated. It has equavalent effectivines when compared the other standart regimens.

---