70 research outputs found
Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell-lung cancer
Vinorelbine, a semisynthetic
vinca alkaloid, represents a welltolerated treatment for elderly patients with advanced non-small-cell lung cancer (NSCLC). We explored the quality of life (QoL) of such patients in a multicenter
randomized trial that compared
vinorelbine treatment with supportive care alone. Methods: Eligible patients were 70 years of age or older,
had stage IV or IIIB NSCLC that was ineligible for radiotherapy, and had a
performance status of 0â2 (a status of fully active to a status of capable of all
self-care but unable to work). Vinorelbine was given intravenously on days 1 and 8 of a 21-day treatment cycle, for a total of six cycles. QoL was evaluated with European Organization for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-LC13, and the QoL data were analyzed by fitting
a linear mixed model for each QoL scale. Survival curves were plotted and were compared with the Mantelâ
Haenszel test. Relative hazards of death and 95% confidence intervals (CIs)
were estimated by the Cox model.
Results: Investigators, blinded to the results,
stopped the trial early because of a low enrollment rate. (From April 1996 to November 1997, 191 of the 350
targeted patients were randomly assigned.) Data from 161 patients have been analyzed. Vinorelbine-treated patients scored better than control patients on QoL functioning scales, and
they reported fewer lung cancerrelated symptoms but reported worse toxicity-related symptoms. There was a
statistically significant (two-sided P = .03) survival advantage for patients receiving vinorelbine; median survival increased from 21 to 28 weeks in the vinorelbine-treated group. The relative
hazard of death for vinorelbine-treated
patients was 0.65 (95% CI = 0.45â0.93).
Conclusion: Vinorelbine improves survival of elderly patients with advanced NSCLC and possibly improves overall
QoL
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