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Abstract : |
Background and objective It is unclear that patients with advanced non-small cell lung cancer (NSCLC) should receive prolonged chemotherapy or the best support, after achieving a maximum tumor response with 4 to 6 initial chemotherapy cycles. The aim of this study is to compare maintenance paclitaxel therapy with observation in advanced NSCLC patients. Methods A total of 166 patients with stageâ…¢B or â…£ NSCLC were treated with four monthly paclitaxel-carboplatin as following: paclitaxel 100 mg/m2 weekly for 3 of 4 weeks with carboplatin (area under the curve[AUC]=6) on day 1. Patients who responded at week 16 were assigned to either weekly paclitaxel therapy(70 mg/m2, 3 of 4 weeks) or observation. Maintenance therapy continued until disease progression, development of intercurrent illness, intolerable toxicity, or investigator decision to terminate treatment. Results There was a longer median time to progression in maintenance therapy compared with observation (P<0.05). One- and two-year survival rates were 65% and 24% in the paclitaxel arm and 59% and 20% in the observation arm, respectively (P>0.05). The performance status and the stage were the independent prognostic factors by Cox regression. Conclusion Maintenance paclitaxel could benefit median time to progression but not survival time in patients who responded to induction chemotherapy. Nevertheless, further evaluation of maintenance therapy should be done before the concept is abandoned., |
