A Study Of Docetaxol Plus Cisplatin Versus Gemcitabine Plus Cisplatin In Treating Advanced Non-small Cell Lung Cancer

Purpose:To compare the efficacy and safety of Docetaxel plus cisplatin and Gemc- itabine plus cisplatin in advanced non-small cell lung cancer.Methods:A total of fifty six advanced non-small cell lung cancer (NSC LC) patients were studied, 27 in DC group (docetaxel plus cisplatin) and 29 in GC group (gemcitabine plus cisplatin) . DC group received a-hour infusion of docetaxel (75mg/m2) on day 1 , and cisplatin 75 mg/m2 on days divided into 1-3 of a 21-day cycle. GC group received gemcitabine 1000mg/m2 on day 1 and 8,and cisplatin 75 mg/m2 on days divided into 1-3 every 3 weeks. The response rate (RR), time to progress (TTP) , mean survive time (MST) and 1-year survival rates of the patients were analyzed.Results:There were fifty six patients (27 in DC arm and 29 in GC arm) received at least two cycles of treatment unless disease progression or unacceptable toxicity was document. The overall response rates were 44.4% for DC (12 partial responses) and 41.4% for GC (one complete response and 11 partial responses ,P=0.818). The disease control rates were 74.0% for DC and 69.0% for GC. The difference did not reach significance in two groups (P=0.675). The median survival times was 10.5 month(s95%CI,9.2 to 11.8 months) and 11.0months(95%CI,10.4 to 11.6 months) for DC and GC, respectively (P=0.52). Median times to tumor progression was 4.6 months and 5.0 months for DC and GC ,respectively (P=0.63). The 1-year survival rates were 33.3% for DC and 37.9% for GC(P=0.722). The main toxicities were leukopenia and thrombocytopenia. The incidence of gradeâ…¢/â…£leukopenia were 40.7% and 31.0% for DC and GC , respectively (P=0.453). Gradeâ…¢/â…£thrombocytopenia was significantly higher with GCthanDC (24% vs 0%,P=0.028). However, there were no thrombocytopenia-related complications in the GC arm. Gradeâ…¢/â…£nause/vomiting (P=0.643), anemia (P=0.632), alopecia (P=0.807) and abnormal electrocardiogram (P=0.453) were significantly more common with GC and DC.Conclusion:Docetaxel plus cisplatin has benefits in terms of comparable objective response rates ,palliative benefits , median times to tumor progression, median survival and reduced toxicity when compared with gemcitabine plus cisplatin in the management of advanced non-small cell lung cancer, the differences in treatment efficacies of DC and GC groups are not significant.