Abstract:
Objective To discuss whether advanced-stage lung cancer patients with uncertain pathological diagnosis can be treated with anti-cancer therapy.
Methods A retrospective study was conducted of 245 lung cancer patients with uncertain pathological diagnosis who were treated in the Thoracic Oncology Department of Tianjin Medical University Cancer Institute and Hospital from January 2011 to December 2015. For each patient, the therapeutic efficacy was evaluated at every two cycles, and toxicity was evaluated at every cycle, but only the most severe toxicities during the whole therapy were recorded.
Results The objective response rate (ORR) and disease control rate (DCR) were 24.1% and 82.1% in non-small cell lung cancer (NSCLC) patients and 48.0% and 88.0% in small cell lung cancer (SCLC) patients, respectively. The median progression-free survival (PFS) and median overall survival (mOS) were 5.7 and 15.9 months in NSCLC patients and 5.8 and 16.5 months in SCLC patients, respectively. Cox regression analysis indicated that sex and NSE were independent impact factors of PFS. One hundred and ninety patients showed symptomatic relief, and the remission rate was 77.6%. One hundred and sixty-four patients developed adverse reactions, and the incidence of adverse reactions was 66.9%. Therapy was interrupted in 14 cases (5.7%).
Conclusions In comparison with canonical treatment, although shorter PFS was found in the treatment by experienced oncologic doctors, the "instant symptom relief" was demonstrated, and the long-term survival was not shorter. In addition, the incidence rate of adverse reactions was similar.