Article (Scientific journals)
Influence of cisplatin-use, age, performance status and duration of chemotherapy on symptom control in advanced non-small cell lung cancer: detailed symptom analysis of a randomised study comparing cisplatin-vindesine to gemcitabine
Vansteenkiste, J.; Vandebroek, J.; Nackaerts, K. et al.
2003In Lung Cancer, 40 (2), p. 191-199
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Keywords :
non-small cell lung cancer; cisplatin-based chemotherapy; gemcitabine; clinical trials, phase III; symptom control; questionnaires; duration of treatment; age factors; performance status
Abstract :
[en] Background: We previously reported that treatment of patients with symptomatic advanced non-small cell lung cancer with single agent Gemcitabine (GEM) resulted in a superior clinical-benefit response rate (RR) compared to cisplatin-based combination chemotherapy. We now report the detailed individual symptom control analysis, and the influence of cisplatin-use, age, performance status (PS) and duration of treatment. Patients and methods: Patients received either GEM (1000 mg/m(2), days 1, 8 and 15) or cisplatin (100 mg/m(2), day 1) plus Vindesine (3 mg/m(2), days 1 and 15) (PV), both every 4 weeks. Scores of 9 symptoms were listed weekly by the patient on visual analogue scales. Improvement of a symptom was defined as 2 consecutive cycles of improvement over baseline. Results: Baseline symptoms in the 169 patients were well balanced between the 2 arms (84 GEM, 85 PV). Both patients with objective response and disease stabilisation had clearly better symptom control than those with disease progression. Symptom control in both arms was similar for 'disease-specific' symptoms such as cough, dyspnea, pain or haemoptysis. Compared to PV, a significantly larger number of GEM-patients had better scores for 'constitutional' items such as anorexia (P = 0.007), ability to carry on with daily activities (P = 0.04) and overall impression of quality-of-life (P = 0.008). Symptom control was very similar in younger (< 65 years) versus older (> 65 years) patients, and only slightly better in those with a Karnofsky PS greater than or equal to 80% compared to those < 80%. Most of the symptom improvement occurred in the first 3 cycles, with some further symptom improvement in the following cycles in the GEM-arm only. Conclusions: Both GEM and PV yield a symptom control rate much higher than expected by the objective tumour RR. GEM is equally effective in controlling 'disease-specific' symptoms, but superior in controlling 'constitutional' symptoms. Most of the symptom control was achieved during the first 3 cycles of treatment, with some further improvement thereafter in the GEM-arm only. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
Disciplines :
Cardiovascular & respiratory systems
Oncology
Author, co-author :
Vansteenkiste, J.
Vandebroek, J.
Nackaerts, K.
Dooms, C.
Galdermans, D.
Bosquee, Léon ;  Centre Hospitalier Universitaire de Liège - CHU > Pneumologie-Allergologie
Delobbe, A.
Deschepper, K.
Van Kerckhoven, W.
Vandeurzen, K.
Deman, R.
D'Odemont, J. P.
Siemons, L.
Van den Brande, P.
Dams, N.
More authors (5 more) Less
Language :
English
Title :
Influence of cisplatin-use, age, performance status and duration of chemotherapy on symptom control in advanced non-small cell lung cancer: detailed symptom analysis of a randomised study comparing cisplatin-vindesine to gemcitabine
Publication date :
May 2003
Journal title :
Lung Cancer
ISSN :
0169-5002
eISSN :
1872-8332
Publisher :
Elsevier Sci Ireland Ltd, Clare, Ireland
Volume :
40
Issue :
2
Pages :
191-199
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 16 March 2011

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