To treat or not to treat non-small-cell lung cancer patients? Current perspectives

Authors
Citation
Pa. Bunn, To treat or not to treat non-small-cell lung cancer patients? Current perspectives, ONCOLOGY-NY, 13(9), 1999, pp. 9-15
Citations number
41
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology
Journal title
ONCOLOGY-NEW YORK
ISSN journal
0890-9091 → ACNP
Volume
13
Issue
9
Year of publication
1999
Supplement
4
Pages
9 - 15
Database
ISI
SICI code
0890-9091(199909)13:9<9:TTONTT>2.0.ZU;2-I
Abstract
In the 1980s, the introduction of cisplatin (Platinol)-based chemotherapy p rolonged survival and improved quality of life inpatients with stage III an d IV non-small-cell lung cancer. More recently, the use of five new chemoth erapeutic agents-docetaxel (Taxotere), gemcitabine (Gemzar), irinotecan (Ca mptosar), paclitaxel (Taxol), and vinorelbine (Navelbine)-has further impro ved treatment results for non-small-cell lung cancer. In advanced disease, randomized trials have shown that combinations of these agents produce supe rior results to older cisplatin-based regimens. AL though the new chemother apeutic agents are more expensive than older drugs, calculations of costs p er year of life gained have shown them to be cost-effective. The concurrent use of chemotherapy and chest radiotherapy for stage IIIB disease has prod uced improvements in survival and quality of life that outweigh increases i n toxicity. Neoadjuvant chemotherapy plus surgery has improved survival in patients with stage IIIA disease and mediastinal lymph node involvement, an d the role of neoadjuvant radiotherapy is being studied in this setting as well. Finally, trials of neoadjuvant strategies using new-agent combination s are also being conducted in patients with stage I and II non-small-cell l ung cancer.