METASTATİK KÜÇÜK HÜCRE DIŞI AKCİĞER KANSERİNDE ORAL VİNORELBİNİN ÜÇÜNCÜ BASAMAK TEDAVİDE ETKİNLİK VE TOKSİSİTE DEĞERLENDİRMESİ: TEK MERKEZ DENEYİMİ

Amaç: Bu çalışma, metastatik küçük hücre dışı akciğer kanserinin (KHDAK) üçüncü basamak tedavisinde oral vinorelbinin etkinlik ve toksisitesini değerlendirmeyi amaçlamaktadır. Materyal ve Metot: Oral vinorelbin, metastatik KHDAK’li 20 hastaya, hastalık progresyonu veya kabul edilemez toksisite gelişinceye kadar her üç haftada bir, birinci ve sekizinci günlerde uygulandı. Bulgular: Hastaların ortanca yaşı 64 (aralık 50-78) olup erkek baskın 9/1 idi. En yaygın iki tümör histolojisi skuamöz hücreli karsinom (%65) ve adenokarsinomdu (%30). Üç hastada parsiyel yanıt, beş hastada stabil hastalık görülürken diğerlerinde progresyon gelişmiştir. Medyan progresyonsuz sağkalım (mPSK) 2 ay (Güven Aralığı [GA] %95=1.3-2.6) ve medyan genel sağkalım (mGS) 8 aydı (%95 GA=0.1-17.5). Ortalama dört kür oral vinorelbin uygulandı. Hiçbir hastada 3/4. derece yan etki görülmedi. Birinci derece anemi hastaların yarısında ve birinci derece nötropeni %20’sinde görüldü. En yaygın hematolojik olmayan yan etkiler bitkinlik (%65), bulantı (%35), ve kabızlıktı (%25). Sonuç: Şu anda üçüncü basamak tedavide standart bir yaklaşım yoktur. Bulgularımız, oral vinorelbinin, nispeten uzun vadeli bir hastalık stabilizasyonu sağlayan, kabul edilebilir toksisite ile önemli bir tedavi seçeneği olabileceğini göstermektedir.

Efficacy and Toxicity Evaluation of Oral Vinorelbine in Third Line Treatment in Metastatic Non-Small Cell Lung Cancer: A Single Center Experience

Aim: This study aimed to evaluate the efficacy and toxicity of oral vinorelbine in the third-line treatment of metastatic non-small cell lung cancer (NSCLC). Materials and Methods: Oral vinorelbine was administered on days one and eight of every three weeks in 20 patients with metastatic non-small cell lung cancer until disease progression or development of unacceptable toxicity. Results: The median age of the patients was 64 (range:50-78) with a male dominance of 9/1. The two most common tumor histologies were squamous cell carcinoma (65%) and adenocarcinoma (30%). Partial response was observed in three patients, while stable disease was seen in five patients, and progression developed in the others. The median progression-free survival (mPFS) was 2 months (95% confidence interval [CI]=1.3-2.6) and the median overall survival (mOS) was 8 months (95% CI=0.1-17.5). On average, four cycles of oral vinorelbine were applied. Grade 3/4 side effects were not seen in any patient. Grade one anemia was observed in half, and 20% had grade one neutropenia. The most common non-haematological side effects were fatigue (65%), nausea (35%), and constipation (25%). Conclusion: Currently, there is no standard approach in third-line therapy. Our findings indicate that oral vinorelbine may be an important treatment option with acceptable toxicity, enabling a relatively long-term disease stabilization.

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