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Indian Journal of Medical and Paediatric Oncology
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Year : 2003  |  Volume : 24  |  Issue : 1  |  Page : 4-8

Clinical profile of non-small cell lung cancer at a teaching Hospital in south India

Department of Oncology, Pathology, & Radiology, Sri Venkateswara Institute Of Medical Sciences, Tirupati-517507

Correspondence Address:
K Sambasivaiah
Department of Oncology, Pathology, & Radiology, Sri Venkateswara Institute Of Medical Sciences, Tirupati-517507

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Source of Support: None, Conflict of Interest: None

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Background: Non-small cell lung carcinoma (NSCLC) is the leading cause of cancer mortality in the world. Surgery is not an option for two thirds of patients, because of advanced disease at the time of diagnosis. Therefore, most patients with NSCLC receive palliative treatment by chemotherapy or radiotherapy or both. Chemotherapy has been shown to improve survival and quality of life. The median survival for advanced NSCLC ranges from 6-10 months. Patients and Methods : To study the epidemiological, clinical and survival patterns., we conducted a retrospective analysis of 54 patients with NSCLC treated at this center between 6th July 2002 to 1st May, 2002. Patients age ranged from 26 to 85 years (median-60 years), 43 were males and 11 females. UICC staging revealed : stage I-4, II-2, III-42 and stage IV in 4 patients. Histological subtypes were squamous-37, adenocarcinoma-11, large cell-3 and poorly differentiated-3. Curative surgery was performed for five patients. Thirty one patients received induction chemotherapy with MIC regimen (cisplatinum 100mg/m2, Ifosfamide 3gr/m2 and Mitomycin 6mg/m2) and one patient received EP regimen. Out of these, twenty two patients received three or more cycles. Four patients received oral etoposide and one patient opted for alternate medicines, three patients died of progressive disease and eleven patients did not receive any treatment. Two patients received Radiotherapy, after completion of the chemotherapy. Both patients died while on radiotherapy. Results : 19 of 32 (72 percent) patients responded to chemotherapy; complete response-6(27 percent), partial response-13 (45 percent). The median survival for patients with advanced disease is 9.9 months (95 percent CI 6.3-13.4). Three patients were post surgery and were not offered adjuvant chemotherapy. Fatigue, anemia and reversible alopecia are the common toxicities encountered in this study. Raised ESR and LDH are associated with poor out come (P0.05). The number of chemotherapy cycles (3) are associated with better survival than the fewer number of chemotherapy. Conclusions: Squamous cell carcinoma is the commonest histological subtype. Adenocarcinoma is more common among non smokers and women. Eighty five percent of patients present with inoperable, advanced disease. Cisplatin based combination chemotherapy results in over all response rate of 75 percent and a medium survival of 9.9 months among advanced NSCLC. Elevated ESR and LDH are associated with poor outcome.

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