Publication:

Cisplatin-etoposide versus paclitaxel-carboplatin along with thoracic radiotherapy in unresectable locally advanced non-small cell lung cancer: a comparison of treatment response

Background Although many chemotherapy regimens are used concurrently with radiotherapy in locally advanced non-small cell lung cancer (NSCLC), the ideal chemotherapy regimen is yet to be determined. The purpose of this study was to compare the therapeutic response of cisplatin-etoposide (EP) and paclitaxel-carboplatin (PC) combined with thoracic radiation in unresectable locally advanced NSCLC.

Methods A quasi-experimental study was conducted from October 2020 to September 2021 at two centers in Dhaka. Patients with unresectable, locally advanced, histology proven NSCLC were enrolled and distributed equally in two arms. Patients underwent 60 Gy in 2 Gy daily fractions, five days/week, for six weeks of thoracic radiotherapy with either cisplatin 50 mg/m2 and etoposide 50 mg/m2/day (arm A), or carboplatin (AUC-2) and paclitaxel (45 mg/m2) (arm B). All the patients were evaluated before, during, and after the completion of the treatment. Follow ups were done at 6 weeks, 12 weeks and 24 weeks following the completion of treatment.

Results Seventy-four patients were distributed equally into two arms. After 6 weeks 3 (8.11%) patients had complete response (CR), 28 (75.68%) had partial response (PR), and 6 (16.22%) had stable disease (SD) in arm-A. In arm-B, 1 (2.71%), 24 (64.86%), 12 (32.43%) patients had CR, PR and SD respectively. In either arm none had progressive disease (PD). After 24 weeks, 5 (13.51%) versus 2 (5.41%) patients had CR, 15 (40.54%) versus 16 (43.24%) had SD, and 4 (10.81%) versus 6 (16.21%) had PD in arm-A and arm-B respectively. PR was 13 (35.14%) in both arms. But these differences were not significant (p>0.05).

Conclusions In unresectable locally advanced non-small cell lung cancer, the short-term treatment response of a cisplatin-etoposide regimen given with concurrent radiation therapy is comparable to that of a paclitaxel-carboplatin regimen.