Number of cycles of chemotherapy in patients with advanced non-small cell lung caner: Efficacy and relationship with histology

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Background: Platinum based regimens are standard first-line treatment in patients with advanced non mall cell lung cancer. We intend to evaluate their effectiveness according to the number of cycles administered, and investigate whether histology is a predictor of benefit from a greater number of infusions. Methods: 124 patients with stage IV NSCLC were evaluated retrospectively. They were divided according to whether they made 4 or 6 cycles of chemotherapy. The schemes used were: Cisplatin / Gemcitabine and Carboplatin / Paclitaxel, at standard doses. We studied the efficacy in both groups according to the most common histologies (adenocarcinoma and squamous cell carcinoma). PFS (progression-free survival) and OS (overall survival) were calculated by the Kaplan-Meier curves and compared by the Log Rank Test. Results: Those who underwent 4 cycles had a PFS of 7.77 months and OS of 12.2 months vs. 8.64 and 10.8 months those who received 6 cycles (p = 0.47, p = 0.76). Within the subgroup with squamous histology (n = 43), PFS and OS were 7.38 and 13.38 months respectively in the group that received 4 cycles vs. 7.97 and 9.76 months in those receiving 6 (p = 0.70, p = 0.32 ). Within adenocarcinoma histology (n = 81), those who received 4 cycle, has a PFS of 8.17 months and they lived 11.56 month, vs 8.96 and 10.79 months for those receiving 6 cycles (p = 0.29, p = 0.88) Conclusions: In our population, a greater number of cycles showed no advantages in terms of progression-free survival or overall survival. Histology is not a predictive factor for deciding how many chemotherapy cycles administer.

Relationship between obesity and survival in advanced breast cancer

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Background: Breast cancer is the second cause of cancer-related deaths. Obesity is defined as an excessive accumulation of fat. The body mass index (BMI) indicates relationship between weight and height and is used to identify obesity, which is associated with increased risk of cancer. Studies have shown the worst prognosis of obese patients undergoing adjuvant therapy. This paper aims to assess progression-free survival (PFS) and overall survival (OS) in relation to BMI, in patients with advanced breast cancer. Methods: We retrospectively analyzed medical records of 132 patients treated in the IONC from 2005 to 2010. We divided the patients into two groups: group A, BMI <30 (not obese), Group B, BMI ≥ 30 (obese). Analysis of SG and TLP were estimated by the Kaplan-Meier method and compared using the log-rank test. Results: The PFS for group A was 16.44 months, and for group B it was 13.08 (p = 0.40). OS was 31.93 and 27.12, respectively (p = 0.31). Regarding BMI and menopausal status, we observed a marked increase in survival for non-obese premenopausal patients with statistical significance. See table below. Conclusions: Patients with BMI <30 had higher survival rates, without reaching statistical significance. This could be due to small sample size and heterogeneity. Another relevant finding is the statistically significant difference in survival that favors premenopausal patients with lower BMI, which raises an area to be studied. This work demonstrates the importance of guiding patients towards a healthier life habit. [Table: see text] [Table: see text]

Concomitant chemoradiotherapy in women with stage II-III breast cancer

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Background: To demonstrate the compliance of radiotherapy and chemotherapy with concomitant taxanes by avoiding delays initiation of that treatment Methods: Retrospective, observational, and descriptive. We analyzed the medical records of 50 patients from June 2006 to December 2010 with an average follow up of 27.26 months (9 months to 56 months), in which all completed conservative surgery. The chemotherapy used was AC x 4 cycles (doxorubicin 60 mg/m2, Cyclophosphamide 600 mg/m2 on day 1 every 21 days) followed by weekly paclitaxel 80 mg/m2 for twelve weeks, concomitant with radiation in the affected breast. Standardized treatment was indicated to patients with positive hormone receptors. Results: Patients`s age averaged 53.58 years (33 years and 74 years) All patients received the planned chemotherapy, with a delay of 63.24 days, from the surgery to the first cycle of chemotherapy (20 days to 110 days. The radiation treatment was initiated in 143.4 days (90 to 205 days) on average after the surgical treatment.It was reported that 8% (n = 4) discontinued the treatment due to the toxicity of the radiation therapy: actinic dermatitis grade 3 and 4. The average number of days without radiation therapy due to toxicity was 6 days (3 to 9 days).With respect to chemotherapy, 22% (11) interrupted it because of hematologic toxicities (neutropenia, thrombocytopenia), constitutional toxicities (fatigue) and arthralgias. Regarding chemotherapy, the average time without treatment was 18 days (1 to 4 cycles).There were no cardiac or lung related adverse events. All other toxicities were well tolerated with concomitant medication. Conclusions: In our population, it is possible to carry out concomitant chemo-radiotherapy with acceptable early toxicities and compliance in patients with breast cancer.