A Comparative Clinical Study of the Docetaxel-Carboplatin combination and the Gemcitabine- Carboplatin combination in Patients with Non Small Cell Lung Cancer

摘要

Back Ground: Non small cell lung cancer (NSCLC) constitutes about 75-80% of all lung cancer cases. In the chemotherapy of NSCLC, a platinum drug can be combined with taxanes or Gemcitabine. Aim: To compare the Docetaxel-Carboplatin (DC) and Gemcitabine-Carboplatin (GC) treatment regimen in patients with NSCLC.Setting And Design: Prospective, Randomized, Open labeled double arm studyMethods: Thirty patients with stage IIIB/IV NSCLC were randomly divided into two groups. The patients of the DC group were treated with Docetaxel (75 mg/m2, day one) and Carboplatin (calculated to give an AUC of 6 mg/ml, day one) and those of the GC group were treated with Gemcitabine (1200 mg/m2, day one and eight) and Carboplatin (day one). Treatment cycles were repeated every 21 days for a period of three cycles. Response and toxicity were assessed using WHO criteria.Results: The patients in both the groups were well balanced for demographics and disease. Objective responses were similar in the two groups; DC group: 20% partial response, 60% stable disease and 20% of progressive disease. GC group: 33.3% partial response, 53.3% stable disease and 13.3% progressive disease. The only significant toxicity was anemia in the DC group. The evaluation of the quality of life of patients in both the groups showed significant change in the incidence of anemia, dysphagia and peripheral neuropathy in the DC group. Alopecia was significantly higher among the patients of the GC group.Conclusion: The toxicity profiles of the Docetaxel-Carboplatin and Gemcitabine- Carboplatin combinations were similar. The Docetaxel-Carboplatin treatment regimen is cost effective for patients. Global quality of health is not improved in either combination, although advantages in some components of ten QOL were apparent.