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Open Access Highly Accessed Research article

Initial partial response and stable disease according to RECIST indicate similar survival for chemotherapeutical patients with advanced non-small cell lung cancer

Lijie He1, Yuee Teng1, Bo Jin1, Mingfang Zhao1, Ping Yu1, Xuejun Hu2, Jingdong Zhang1, Songbai Li3, Yaling Gao4 and Yunpeng Liu1*

Author Affiliations

1 Department of Medical Oncology, The First Hospital, China Medical University, NO.155, North Nanjing Street, Heping District, Shenyang City, China

2 Department of Respiratory Medicine, The First Hospital, China Medical University, NO.155, North Nanjing Street, Heping District, Shenyang City, China

3 Department of Radiology, The First Hospital, China Medical University, NO.155, North Nanjing Street, Heping District, Shenyang City, China

4 Department of Medical Oncology, The Oncology Hospital of Liaoning Province in China. NO. 44, Xiaoheyan Road, Dadong District, Shenyang City, China

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BMC Cancer 2010, 10:681  doi:10.1186/1471-2407-10-681

Published: 14 December 2010

Abstract

Background

Stable disease (SD) has ambiguous clinical significance for patients according to the dominant Response Evaluation Criteria in Solid Tumours (RECIST). The primary aims of the study were: (1) to clarify the clinical significance of SD by comparing the progression-free survival (PFS) of response and SD patients with advanced non-small cell lung cancer (NSCLC) after the first two courses of the standard first-line platinum-based chemotherapy; (2) to explore the relationship between the percentage change in tumour size and PFS among initial SD patients, in order to provide some guidance for clinicians in deciding continuation/termination of the current treatment at a relative early time.

Methods

A total of 179 advanced NSCLC patients whose baseline CT image was available for review were included in the study. Another CT image was taken in the initial assessment after chemotherapy. A comparison of PFS between initial partial response (PR) and SD was used to determine whether significant differences exist. The relationship between the early percentage of change in tumour size of initial SD patients and their PFS was investigated. In addition, overall survival (OS), the secondary endpoint in this study, was investigated as well.

Results

Patients with initial PR are not significantly distinguished from those with initial SD when their PFS is concerned (median PFS 249 days [95% confidence interval, 187-310 days] versus 220 days [95% confidence interval, 191-248 days], p > 0.05). Their median OS was 364 days (95% confidence interval, 275-452 days) for the initial PR patients versus 350 days (95% confidence interval, 293-406 days) for the initial SD patients, which suggests no significant difference as well p > 0.05). In addition, all the initial SD patients enjoyed similar PFS and OS.

Conclusions

Initial PR and SD enjoy similar PFS and OS for patients with advanced NSCLC. Within the initial SD subgroup, different percentages of tumour shrinkage or increase undergo similar PFS and OS. RECIST remains a reliable norm in assessing the effectiveness of chemotherapy for patients with advanced NSCLC before functional assessment has been integrated into the criteria.