Different chemotherapy regimens in combination therapy with radiation to treat locally advanced NSCLC

The authors compared the effectiveness of different chemotherapy agents in combination with radiation. They stated that a combination of etoposide (Etopophos) and cisplatin (Platinol) was more effective then docetaxel (Taxotere) and cisplatin when combined with radiation therapy.

Current recommendations for the treatment of locally advanced (cancer that has spread near where it originated) non-small cell lung cancer (NSCLC) suggest using a combination of chemotherapy and radiotherapy. While the most common chemotherapy regimen consists of etoposide and cisplatin, it is possible that another combination might be more effective. Docetaxel is a chemotherapy that has been shown to be effective in combination with cisplatin. It is not clear if this combination is more effective than etoposide and cisplatin.

The study aimed to compare whether a docetaxel/cisplatin (DP) chemotherapy regimen is more effective than an etoposide/cisplatin (EP) regimen, in combination with radiation, at treating patients with locally advanced NSCLC.

This study examined the records of 105 patients. 55 of these patients were treated with DP and 50 patients were treated with EP. All patients were treated with similar levels of radiation. The average follow-up for patients treated with DP was 19 months. Average follow-up for patients treated with EP was 27 months.

Progression free survival (time from beginning trial to disease progression) was 9 months longer in patients treated with EP compared to patients treated with DP. Average overall survival (time from beginning trial until death) was 41 months in patients treated with EP. This was significantly longer than the 20 months for patients treated with DP. Patients treated with EP were 54% more likely to have survived than those treated with DP.

Most side effects were similar between the two treatment combinations with two exceptions. 6% of patients treated with DP experienced pulmonary side effects and 20% experienced skin toxicities.

The authors concluded that the combination of etoposide and cisplatin was more effective than the combination of docetaxel and cisplatin, when used in combination with radiotherapy.

The number of patients in the study was very small. In addition, they study was not randomized and had a much greater number of men than women. Most cancers in this study were 1 NSCLC subtype, rather than a collection of patients with more diverse subtypes.