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Panminerva Medica 2001 Marzo;43(1):15-9

lingua: Inglese

Gemcitabine as single agent therapy in advanced non small cell lung cancer and quality of life in the elderly

Bianco V., Di Girolamo B., Pignatelli E., Speranza I., Florio G., Gemma D., Girolami M., Vietri F., Marchei P.

From the Department of Experimental Medicine and Pathology Medical Oncology Unit Umberto I Polyclinic University “La Sapienza”, Roma, Italy


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Background. The aim of ­this ­study is to ­test the effi­cacy of gem­cit­a­bine as ­single ­agent ­therapy in ­advanced non-­small ­cell ­lung ­cancer in the eld­erly by the eval­u­a­tion of the clin­ical ­response, the sur­vival ­increase and the ­quality of ­life.
Methods. Nineteen ­patients (age >65 ­years) ­with a PS >2, ­bearing an ­advanced non-­small ­cell ­lung ­cancer (IIIb-IV) not ­treated ­with chem­o­therapy ­before, ­were ­charged ­between December 1996 and December 1998. Sixteen ­patients ­were ­treated ­with gem­cit­a­bine at the ­dose of 1000 mg/mq 1-8-15 ­every 28 ­days. CT ­scan, X-rays and skel­etal scin­tig­raphy ­were ­used in the eval­u­a­tion of the ther­a­peutic ­response. The tox­icity was esti­mated by fol­lowing WHO ­indexes. The ­quality of ­life and the mod­ifi­ca­tion of the spe­cific symp­toms ­were esti­mated by par­tic­ular ­tests (Spitzer Index, ­IADL, ­EORTC-LC13).
Results. One com­plete ­response (6%), 4 par­tial ­responses (25%), 7 ­cases of ill­ness sta­bil­iza­tion (43%), 4 ­cases of ill­ness pro­gres­sion, ­were ­shown. One ­year of sur­vival was ­found in 43% of ­cases ­with a 14 ­week of ther­a­peutic ­response and a ­global sur­vival ­ratio of 12.4 ­weeks. Only 2 ­cases (12.5) of ­medium ­grade G3-leu­co­penia ­were ­found. All ­patients ­improved ­their ­quality of ­life (­IADL and Spitzer ­indexes) ­with reduc­tion of symp­toms, (­EORTC-LC13) and ­increase of ­self-­agin and rela­tion­ships.
Conclusions. The effec­tive­ness of gem­cit­a­bine as ­single ­agent ­therapy as not yet ­been ­tested due to the ­scanty ­number of ­patients, nev­er­the­less it ­must be con­sid­ered in rela­tion to the improve­ment of the ­patient’s ­quality of ­life.

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