Effectiveness and toxicity of adjuvant chemotherapy in patients with non-small cell lung cancer

ABSTRACT Objective: Adjuvant chemotherapy (AC) improves survival of patients with resected non-small cell lung cancer (NSCLC). However, the cisplatin-vinorelbine regimen has been associated with a significant risk of clinically relevant toxicity. We sought to evaluate the effectiveness, safety, and feasibility of AC for NSCLC patients in a real-world setting. Methods: This was a single-center, retrospective cohort study of patients with stage I-III NSCLC undergoing surgery with curative intent between 2009 and 2018. AC was administered at the discretion of physicians. The patients were divided into two groups: AC group and no AC (control) group. Study outcomes included overall survival (OS) and recurrence-free survival (RFS), as well as the safety profile and feasibility of the cisplatin-vinorelbine regimen in a real-world setting. Results: The study involved 231 patients, 80 of whom received AC. Of those, 55 patients received the cisplatin-vinorelbine regimen. Survival analyses stratified by tumor stage showed that patients with stage II NSCLC in the AC group had better RFS (p = 0.036) and OS (p = 0.017) than did those in the no AC group. Among patients with stage III NSCLC in the AC group, RFS was better (p < 0.001) and there was a trend toward improved OS (p = 0.060) in comparison with controls. Of those who received the cisplatin-vinorelbine regimen, 29% had grade 3-4 febrile neutropenia, and 9% died of toxicity. Conclusions: These results support the benefit of AC for NSCLC patients in a real-world setting. However, because the cisplatin-vinorelbine regimen was associated with alarming rates of toxicity, more effective and less toxic alternatives should be investigated.

Bibliographic Details

Main Authors:	Harada,Guilherme, Neffa,Maria Fernanda Batistuzzo Vicentini, Bonadio,Renata Colombo, Mendoza,Elizabeth Zambrano, Caparica,Rafael, Lauricella,Letícia Leone, Takagaki,Teresa Yae, Roitberg,Felipe Santa Rosa, Terra,Ricardo Mingarini, Castro Jr,Gilberto De
Format:	Digital revista
Language:	English
Published:	Sociedade Brasileira de Pneumologia e Tisiologia 2021
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132021000300200
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