Combined treatment in advanced stages (IIIb-IV) of non-small cell lung cancer.

Chemotherapy regimens based on platinum represent the reference standards in Non-Small Cell Lung Cancer (NSCLC) and when it is associated with ra- diotherapy and/or surgery (combined treat- ment) it improves survival of patients. Aim of this study was to estimate the efficacy of chemotherapy, based on high-dose epirubicin plus cisplatin, associated with surgery and/or radiotherapy. Twenty-four inoperable NSCLC patients (15 pts in stage IIIb and 9 in stage IV) were treated with epirubicin (120 mg/m 2 ) plus cisplatin (60 mg/m 2 ), every three weeks for at least 3 cycles up to a maximum of 6. A total of 109 treatment cycles (epirubicin plus cis- platin) were administered and two of 24 pa- tients achieved full response (CR), 9 showed partial response (PR), for an overall response rate of 45.8%, 8 patients (33.4%) achieved stable disease (SD) and 5 (20.8%) progres- sive disease (PD). Leukopenia aroses in 81.9% of the cycles, anaemia in 36.6% and thrombocytopenia in 14%. After chemothera- py, nausea/vomiting was present in 33.3% of patients, while in a small number of cases there were also mucositis, diarrhea, fever, phlebitis, transaminase increase and electro- cardiographic anomalies. Upon entry, at the end of therapy patients underwent restaging (CT, bronchoscopy, bone scintiscan) to evalu- ate the possibility of surgical resection; 15 out of 24 patients completed treatment with radio- therapy (40-60 Gy) and then were re-evaluated for surgery. Five patients underwent complete surgical resection of the neoplasia (4 after chemotherapy and one after radiotherapy). After 1 year survival was 66.6% for all pa- tients. Combined treatment in advanced NSCLC showed a good response and survival after 1 year.