Gürsel ÇOK, Serdar SOYER, Tülin AYSAN, Tuncay GÖKSEL

Effectiveness of gemcitabine as second-line chemotherapy in non-small cell lung cancer

Küçük hücreli dışı akciğer kanseri (KHDAK)’nde platin bazlı kemoterapiden sonra kullanılan ikinci basamak kemoterapiyle ilgili belirsizlikler devam etmektedir. Bu retrospektif çalışmada daha önce kemoterapi alan ve yanıt alınamayan veya daha sonra nükseden KHDAK’lı 34 hastada ikinci basamak kemoterapi için kullanılan tek ajan gemsitabinin etkisi değerlendirilmiştir. Gemsitabin, üç haftada bir, birinci ve sekizinci günlerde ve 1250 mg/m2 dozunda intravenöz olarak kullanılmıştır. Median yaşın 50 olduğu ve en çok skuamöz hücreli karsinom (%44.1) tipinin görüldüğü belirlenmiştir. Yanıt oranları değerlendirildiğinde tam yanıtın hiçbir hastada olmadığı, yedi hastada (%20.6) kısmi yanıtın elde edildiği ve median sağkalımın 29 hafta olduğu saptanmıştır. Bir yıllık sağkalım olasılığının %26.5, progresyona kadar geçen median sürenin ise 13 hafta olduğu belirlenmiştir. Uygulanan toplam 119 kemoterapi siklusu içerisinde grade III ve IV toksisitenin siklusların sadece %2.5’inde ortaya çıktığı ve bu hasta grubunda gemsitabinin iyi tolere edildiği görülmüştür. Çalışmanın tüm sonuçları değerlendirildiğinde KHDAK’nin ikinci basamak kemoterapisinde tek ajan olarak gemsitabinin orta derecede etkili olduğu, iyi tolere edildiği ve tedavi seçenekleri arasında düşünülebileceği sonucuna varılmıştır.

Küçük hücreli dışı akciğer kanserinde ikinci basamak kemoterapi olarak gemsitabinin etkinliği

The role of a second-line chemotherapy after an initial treatment with a platinum-based regimen remains largely undefined. In this retrospective clinical effectiveness study, gemcitabine as monotherapy was evaluated in the second-line chemotherapy in 34 non-small cell lung cancer (NSCLC) cases that had been previously received chemotherapy and did not respond to the treatment or presented with relapses. Gemcitabine was given intravenous at a dose of 1250 mg/m2 on days one, eight every three weeks. Median age was 50 years and squamous cell carcinoma was the most common malignancy (44.1%). No patient had a complete response, 7 (20.6%) patients had a partial response. The median survival was 29 weeks. The 1-year survival probability was estimated at 26.5%. Median time to disease progression was 13 weeks. Gemcitabine was well tolerated in this patient population. Among totally 119 chemotherapy cycles, we observed grade 3 and 4 toxicities only in 2.5% of cycles. As a result of the study, single agent gemcitabine is found to be tolerable and to have moderate effectiveness in the second-line chemotherapy in NSCLC. It should be placed among treatment options.

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