| Background:With the impacting of risk factors, such as smoking and environmental pollution, the incidence of lung cancer increased year by year. It shows that lung cancer has become the leading cause among cancer-related deaths. Because the early symptoms of lung cancer tend to be minor, the majorities of cases are diagnosed when there are metastases and can’t be treated by surgery. Multidisciplinary therapy is needed when treated with lung cancer, which includes surgery, chemotherapy, radiation therapy, molecular targeted therapy and so on, in which chemotherapy plays an important role, especially in patients with advanced lung cancer.In fact, lots of patients with inoperable lung cancer accept chemotherapy after comprehensive assessment. As we all know, there are some adverse reactions with chemotherapy, including gastrointestinal reactions, bone marrow suppression, alopecia and so on. The severity of chemotherapy side effects often varies in different patients. So it confuses us whether there is a relationship between the effect of chemotherapy and the severity of adverse reactions and whether we can predict the effect of chemotherapy by assessing the severity of chemotherapy adverse reactions.Objective:To analyze the short-term effect and adverse reactions of docetaxel and platinum agents in patients with advanced lung adenocarcinoma, and discuss the relationship between efficacy and adverse reactions.Methods:In accordance with retrospective analysis, collect clinical data of patients hospitalized in department of respiration in Shangdong Provincial Hospital during January 1,2013 to December 31,2014, who were diagnosed with lung adenocarcinoma pathologically and received chemotherapy of docetaxel and platinum agents, as nedaplatin, cisplatin and carboplatin, for at least two cycles. To evaluate the adverse reactions the enrolled patients suffered during chemotherapy, and classify the adverse reactions according to WHO toxicity grading standards of anticancer drugs. And the patients were divided into two groups according to the severity of the adverse reactions, as group 1 of mild adverse reactions and group 2 with moderate and severe adverse reactions. The efficacy after two cycles of chemotherapy was evaluated according to the response evaluation criteria in solid tumors (RECIST). Then analyze whether there are statistically significant differences between the efficacy and adverse reactions of chemotherapy.Results:91 patients were enrolled, aged 35-78 years old,45 male cases and 46 female cases. Group 1 included 48 patients with a median age of 58 years old, including patients with level 0 and Ⅰ adverse reactions.43 patients were enrolled in Group 2 who suffered from level Ⅱ, Ⅲ and Ⅳ adverse reactions, with a median age of 59 years old. And the two groups were comparable clinically.After two cycles’chemotherapy, there were 0 cases with complete remission (CR), 23 cases with partial remission (PR),40 cases with stable disease (SD) and 28 cases with progressive disease (PD), and the response rate (CR+PR) was 25.3%(23/91), and disease control rate (CR+PR+SD) was 69.2%(63/91).The common adverse reactions were gastrointestinal reactions and bone marrow suppression, such as Ⅰ, Ⅱ degree of bone marrow suppression, nausea, constipation and vomiting. Grade Ⅲ and Ⅳ adverse reactions were rare. There were 26 cases with no significant adverse reactions during chemotherapy.After two cycles’chemotherapy using docetaxel and platinum agents, the response rate of group 1 and group 2 were 18.8%(9/48),32.6%(14/43), and the disease control rate were 62.5%(30/48),76.7%(33/43) respectively. The values of P were 0.153 and 0.175 respectively, so there were no statistically significant differences about the efficacy between the two groups.For female patients, the response rate and disease control rate were 32.6%(15/46) and 84.8%(39/46). And there were 19 cases with mild adverse reaction enrolled into group A and 27 cases with moderate and severe adverse reaction enrolled into group B. The response rate of group A and group B were 15.8%(3/19),44.4%(12/27), and the disease control rate were 73.7%(14/19),92.6%(25/27) respectively. The values of P were 0.058 and 0.107 respectively, so there were no statistically significant differences about the efficacy of chemotherapy between the two groups of female patients.Conclusions:(1) The total response rate of docetaxel and platinum agents in the treatment of advanced lung adenocarcinoma is 25.3% and disease control rate is 69.2%.(2) For the female, the response rate is 32.6%, disease control rate 84.8%, and the effect is better than that of the general level.(3) Using the chemotherapy of docetaxel and platinum agents for patients with advanced lung adenocarcinoma, the incidence rate of adverse reactions is 71.4%. The common adverse reactions are gastrointestinal reactions and hematologic toxicity.(4) Whether for the total patients or the females alone, the response rate and disease control rate in patients with moderate or severe adverse reactions are higher than that in patients with no or mild adverse reactions. But it shows no statistically significant differences in efficiency. So there is no certain correlation between efficacy and adverse reactions of chemotherapy for patients with lung adenocarcinoma. |
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