Efficacy Of Chemotherapy In Patients With Advanced Adenosquamous Carcinoma Of Lung

Objective:To investigate the efficacy, safety and prognostic factors of chemotherapy for patients with advanced adenosquamous carcinoma(ASC) of the lung.Methods:The data of patients with stage IIIB or IV adenosquamous carcinoma of the lung were retrospectively analyzed regarding efficacy, safety,and prognostic factors of chemotherapy.Results:A total of 36 patients were included in this study with median age was 54 years old, there were 24 males and 12 females, an Eastern Cooperative Oncology Group performance status of 0 to 2,21 cases with central type and 15 cases with peripheral type,17 cases with smoking history and 19 cases without smoking history.All patients received platinum-based doublet regimens as first-line chemotherapy. The objective response rate (ORR) of gemcitabine plus cisplatin (GP regimen) was 47.8%(CR 0 case, PR 11 case, SD 6 case and PD 6 case), which was higher than other schemes but not reach significant statistically. The progression-free survival (PFS) of gemcitabine plus cisplatin (GP regimen) was 4.6 months, which were higher than other schemes but not reach significant statistically. The difference of adverse reaction between the two schemes was not significant.The difference of PFS for first-line chemotherapy in different baseline characteristics was not statistically significant.As for second-line chemotherapy, the ORR and PFS of pemetrexed was 80.0% and 10.0 months, respectively, both of which were significantly higher than the docetaxel group (P=0.000). The adverse reaction of the two schemes was tolerable.The smoking history,performance status and chemotherapy regimens were the independent factors for the PFS of second-line chemotherapy.The overall survival (OS) of those who recieved GP regimen as first-line and pemetrexed as second-line chemotherapy was 21.0 months, significantly longer than other combination of first-line and second-line regimens(P=0.009). The location of tumor performance status and combination of chemotherapy regimens were the independent factors for the OS.Conclusion:1.The objective efficacy and PFS of gemcitabine plus cisplatin as first-line chemotherapy for patients with advanced adenosquamous carcinoma(ASC) of the lung was not significantly superior to other schemes.2.The objective efficacy and PFS of pemetrexed as second-line chemotherapy for patients with advanced adenosquamous carcinoma(ASC) of the lung was significantly better than the docetaxel group, the PFS of second-line chemotherapy was also influenced by smoking history and performance status of patients.3.First-line chemotherapy with gemcitabine plus cisplatin followed by pemetrexed as second-line chemotherapy may extend the OS of patients with advanced adenosquamous carcinoma of the lung,besides, the OS was influenced by the location of tumor and performance status of patients.