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dc.contributor.authorRanson, Malcolm R
dc.contributor.authorDavidson, Neville
dc.contributor.authorNicolson, Marianne
dc.contributor.authorFalk, Stephen J
dc.contributor.authorCarmichael, Jim
dc.contributor.authorLopez, Pedro
dc.contributor.authorAnderson, Heather
dc.contributor.authorGustafson, Nancy
dc.contributor.authorJeynes, Allison
dc.contributor.authorGallant, Giles
dc.contributor.authorWashington, Terri
dc.contributor.authorThatcher, Nick
dc.date.accessioned2009-11-23T10:07:07Z
dc.date.available2009-11-23T10:07:07Z
dc.date.issued2000-07-05
dc.identifier.citationRandomized trial of paclitaxel plus supportive care versus supportive care for patients with advanced non-small-cell lung cancer. 2000, 92 (13):1074-80 J. Natl. Cancer Inst.en
dc.identifier.issn0027-8874
dc.identifier.pmid10880550
dc.identifier.doi10.1093/jnci/92.13.1074
dc.identifier.urihttp://hdl.handle.net/10541/86642
dc.description.abstractBACKGROUND: In phase II trials, paclitaxel has been shown to have antitumor activity in patients with advanced non-small-cell lung cancer (NSCLC). However, the survival and quality-of-life (QOL) benefits of paclitaxel used as a single agent compared with supportive care alone have not been assessed in a randomized clinical trial. METHODS: A total of 157 patients with stage IIIB or IV NSCLC who had received no prior chemotherapy were randomly assigned to receive either best supportive care alone (78 patients) or paclitaxel plus supportive care (79 patients). Paclitaxel was administered as a 3-hour intravenous infusion every 3 weeks. Supportive care included palliative radiotherapy and supportive therapy with corticosteroids, antibiotics, analgesics, antiemetics, transfusions, and other symptomatic therapy as required. The primary end point of the study was survival. Time to disease progression, response rate, adverse events, and QOL were secondary end points. RESULTS: Pretreatment characteristics were evenly distributed between the two arms. Survival was statistically significantly better in the paclitaxel plus supportive care arm than in the supportive care alone arm (two-sided P =.037) (median survival = 6.8 months versus 4.8 months). Cox multivariate analysis showed paclitaxel plus supportive care to be statistically significantly associated with improved survival (two-sided P =.048). QOL was similar for both treatment arms, except for the functional activity score of the Rotterdam Symptom Checklist, where QOL data statistically significantly favored the paclitaxel plus supportive care arm (two-sided P =.043). CONCLUSION: The addition of paclitaxel to best supportive care significantly improved survival and time to disease progression compared with best supportive care in patients with advanced NSCLC and may improve some aspects of QOL.
dc.language.isoenen
dc.subjectLung Canceren
dc.subjectCancer Stagingen
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshAntineoplastic Agents, Phytogenic
dc.subject.meshCarcinoma, Non-Small-Cell Lung
dc.subject.meshDisease Progression
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshLung Neoplasms
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshNeoplasm Staging
dc.subject.meshPaclitaxel
dc.subject.meshProportional Hazards Models
dc.subject.meshQuality of Life
dc.subject.meshSurvival Analysis
dc.subject.meshTreatment Outcome
dc.titleRandomized trial of paclitaxel plus supportive care versus supportive care for patients with advanced non-small-cell lung cancer.en
dc.typeArticleen
dc.contributor.departmentChristie Hospital and Wythenshawe Hospital, Manchester, U.K. malcolm.ranson@man.ac.uken
dc.identifier.journalJournal of the National Cancer Instituteen
html.description.abstractBACKGROUND: In phase II trials, paclitaxel has been shown to have antitumor activity in patients with advanced non-small-cell lung cancer (NSCLC). However, the survival and quality-of-life (QOL) benefits of paclitaxel used as a single agent compared with supportive care alone have not been assessed in a randomized clinical trial. METHODS: A total of 157 patients with stage IIIB or IV NSCLC who had received no prior chemotherapy were randomly assigned to receive either best supportive care alone (78 patients) or paclitaxel plus supportive care (79 patients). Paclitaxel was administered as a 3-hour intravenous infusion every 3 weeks. Supportive care included palliative radiotherapy and supportive therapy with corticosteroids, antibiotics, analgesics, antiemetics, transfusions, and other symptomatic therapy as required. The primary end point of the study was survival. Time to disease progression, response rate, adverse events, and QOL were secondary end points. RESULTS: Pretreatment characteristics were evenly distributed between the two arms. Survival was statistically significantly better in the paclitaxel plus supportive care arm than in the supportive care alone arm (two-sided P =.037) (median survival = 6.8 months versus 4.8 months). Cox multivariate analysis showed paclitaxel plus supportive care to be statistically significantly associated with improved survival (two-sided P =.048). QOL was similar for both treatment arms, except for the functional activity score of the Rotterdam Symptom Checklist, where QOL data statistically significantly favored the paclitaxel plus supportive care arm (two-sided P =.043). CONCLUSION: The addition of paclitaxel to best supportive care significantly improved survival and time to disease progression compared with best supportive care in patients with advanced NSCLC and may improve some aspects of QOL.


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