E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung

Tapas Kumar Das, Pabitra Das, Sunita Das, Arpan Jana.

Abstract
Background: The worldwide epidemiology of lung cancer is ever changing, and non-squamous non-small-cell lung cancer (NSCLC) in never-smoking women has been gradually increasing. In Indian population, adenocarcinoma lung was more common in never smoker persons. Approximately 70–80% of lung cancer cases are NSCLC. Most of NSCLC patients present with advanced disease or brain metastasis. The prognosis of patients with advanced NSCLC is generally considered poor, with a median survival of 9–11 months and a 2-year survival around 20–30%. There are no enough data in Eastern India regarding disease response, treatment-related toxicity, overall survival, and progression-free survival in advanced adenocarcinoma lung treated with chemotherapy and radiotherapy.

Objectives: The objectives of this study were to compare disease response, toxicity, overall survival, and progression-free survival in advanced adenocarcinoma lung treated as first line with pemetrexed/carboplatin versus paclitaxel/carboplatin.

Materials and Methods: A total of 123 patients were placed in Group A and another 117 in Group B (stage III disease). Group A patients were treated with pemetrexed 500 mg/m2 and carboplatin area under the concentration (AUC) 6 every 3 week. Group B patients were treated with carboplatin at dose AUC 6 and paclitaxel 200 mg/m2 administered 3 weekly. Dose of radiation was planned 60 Gy in 30# for 6 weeks in conventional fractionation schedule 3 weeks after completion of chemotherapy.

Results: Hematological toxicities were Grade 3 anemia 27 (22%) in Group A and 29 (24.8%) Group B, Grade 3 neutropenia 34 (27.6%) in Group A and 33 (28.2%) in Group B, and Grade 4 neutropenia 5 (4%) in Group A and 4 (3.4%) in Group B. Grade 3 sensory neuropathy was seen in Group B 17 (14.5%). There was no Grade 3 or Grade 4 sensory neuropathy in Group A. Grade 3 fatigue was seen in Group B 19 (16.2%). Grade 3 diarrhea was seen 9 (7.3%) in Group A and 8 (6.8%) in Group B. Overall response rate was 63 (51.2%) in Group A and 43 (36.8%) in Group B. The complete response of disease was 19 (15.4%) in Group A and 6 (5.1%) in Group B. The partial response was 44 (34.6%) in Group A and 37 (31.6%) in Group B. Stable disease was 41 (33.3%) in Group A and 51 (43.6%) in Group B. The progressive disease was 19 (15.4%) in Group A and 23 (19.6%) in Group B. Median overall survival was 14.6 months in Group A and 14.4 months in Group B.

Conclusion: In our study, pemetrexed/carboplatin provides better efficacy and tolerance, a reduced need for supportive therapies, and more convenient administration than paclitaxel/carboplatin for the first-line treatment of patients with advanced adenocarcinoma lung.

Key words: Adenocarcinoma; Chemotherapy; Overall response


 
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How to Cite this Article
Pubmed Style

Das TK, Das P, Das S, Jana A. Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung. Int J Med Sci Public Health. 2019; 8(3): 243-247. doi:10.5455/ijmsph.2019.0102028012019


Web Style

Das TK, Das P, Das S, Jana A. Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung. http://www.ijmsph.com/?mno=27801 [Access: July 18, 2019]. doi:10.5455/ijmsph.2019.0102028012019


AMA (American Medical Association) Style

Das TK, Das P, Das S, Jana A. Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung. Int J Med Sci Public Health. 2019; 8(3): 243-247. doi:10.5455/ijmsph.2019.0102028012019



Vancouver/ICMJE Style

Das TK, Das P, Das S, Jana A. Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung. Int J Med Sci Public Health. (2019), [cited July 18, 2019]; 8(3): 243-247. doi:10.5455/ijmsph.2019.0102028012019



Harvard Style

Das, T. K., Das, . P., Das, . S. & Jana, . A. (2019) Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung. Int J Med Sci Public Health, 8 (3), 243-247. doi:10.5455/ijmsph.2019.0102028012019



Turabian Style

Das, Tapas Kumar, Pabitra Das, Sunita Das, and Arpan Jana. 2019. Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung. International Journal of Medical Science and Public Health, 8 (3), 243-247. doi:10.5455/ijmsph.2019.0102028012019



Chicago Style

Das, Tapas Kumar, Pabitra Das, Sunita Das, and Arpan Jana. "Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung." International Journal of Medical Science and Public Health 8 (2019), 243-247. doi:10.5455/ijmsph.2019.0102028012019



MLA (The Modern Language Association) Style

Das, Tapas Kumar, Pabitra Das, Sunita Das, and Arpan Jana. "Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung." International Journal of Medical Science and Public Health 8.3 (2019), 243-247. Print. doi:10.5455/ijmsph.2019.0102028012019



APA (American Psychological Association) Style

Das, T. K., Das, . P., Das, . S. & Jana, . A. (2019) Prospective comparative study of pemetrexed and carboplatin versus paclitaxel and carboplatin as first-line chemotherapy in adenocarcinoma lung. International Journal of Medical Science and Public Health, 8 (3), 243-247. doi:10.5455/ijmsph.2019.0102028012019





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