Skip to main content

Cisplatin and etoposide versus carboplatin and paclitaxel with concurrent radiotherapy for stage III non-small-cell lung cancer: an analysis of Veterans Health Administration data.

Publication ,  Journal Article
Santana-Davila, R; Devisetty, K; Szabo, A; Sparapani, R; Arce-Lara, C; Gore, EM; Moran, A; Williams, CD; Kelley, MJ; Whittle, J
Published in: J Clin Oncol
February 20, 2015

PURPOSE: The optimal chemotherapy regimen to use with radiotherapy in stage III non-small-cell lung cancer is unknown. Here, we compare the outcome of patents treated within the Veterans Health Administration with either etoposide-cisplatin (EP) or carboplatin-paclitaxel (CP). METHODS: We identified patients treated with EP and CP with concurrent radiotherapy from 2001 to 2010. Survival rates were compared using Cox proportional hazards regression models with adjustments for confounding provided by propensity score methods and an instrumental variables analysis. Comorbidities and treatment complications were identified through administrative data. RESULTS: A total of 1,842 patients were included; EP was used in 27% (n = 499). Treatment with EP was not associated with a survival advantage in a Cox proportional hazards model (hazard ratio [HR], 0.97; 95% CI, 0.85 to 1.10), a propensity score matched cohort (HR, 1.07; 95% CI, 0.91 to 1.24), or a propensity score adjusted model (HR, 0.97; 95% CI, 0.85 to 1.10). In an instrumental variables analysis, there was no survival advantage for patients treated in centers where EP was used more than 50% of the time as compared with centers where EP was used in less than 10% of the patients (HR, 1.07; 95% CI, 0.90 to 1.26). Patients treated with EP, compared with patients treated with CP, had more hospitalizations (2.4 v 1.7 hospitalizations, respectively; P < .001), outpatient visits (17.6 v 12.6 visits, respectively; P < .001), infectious complications (47.3% v 39.4%, respectively; P = .0022), acute kidney disease/dehydration (30.5% v 21.2%, respectively; P < .001), and mucositis/esophagitis (18.6% v 14.4%, respectively; P = .0246). CONCLUSION: After accounting for prognostic variables, patients treated with EP versus CP had similar overall survival, but EP was associated with increased morbidity.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

February 20, 2015

Volume

33

Issue

6

Start / End Page

567 / 574

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Treatment Outcome
  • Survival Rate
  • Randomized Controlled Trials as Topic
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Santana-Davila, R., Devisetty, K., Szabo, A., Sparapani, R., Arce-Lara, C., Gore, E. M., … Whittle, J. (2015). Cisplatin and etoposide versus carboplatin and paclitaxel with concurrent radiotherapy for stage III non-small-cell lung cancer: an analysis of Veterans Health Administration data. J Clin Oncol, 33(6), 567–574. https://doi.org/10.1200/JCO.2014.56.2587
Santana-Davila, Rafael, Kiran Devisetty, Aniko Szabo, Rodney Sparapani, Carlos Arce-Lara, Elizabeth M. Gore, Amy Moran, Christina D. Williams, Michael J. Kelley, and Jeffrey Whittle. “Cisplatin and etoposide versus carboplatin and paclitaxel with concurrent radiotherapy for stage III non-small-cell lung cancer: an analysis of Veterans Health Administration data.J Clin Oncol 33, no. 6 (February 20, 2015): 567–74. https://doi.org/10.1200/JCO.2014.56.2587.
Santana-Davila R, Devisetty K, Szabo A, Sparapani R, Arce-Lara C, Gore EM, et al. Cisplatin and etoposide versus carboplatin and paclitaxel with concurrent radiotherapy for stage III non-small-cell lung cancer: an analysis of Veterans Health Administration data. J Clin Oncol. 2015 Feb 20;33(6):567–74.
Santana-Davila, Rafael, et al. “Cisplatin and etoposide versus carboplatin and paclitaxel with concurrent radiotherapy for stage III non-small-cell lung cancer: an analysis of Veterans Health Administration data.J Clin Oncol, vol. 33, no. 6, Feb. 2015, pp. 567–74. Pubmed, doi:10.1200/JCO.2014.56.2587.
Santana-Davila R, Devisetty K, Szabo A, Sparapani R, Arce-Lara C, Gore EM, Moran A, Williams CD, Kelley MJ, Whittle J. Cisplatin and etoposide versus carboplatin and paclitaxel with concurrent radiotherapy for stage III non-small-cell lung cancer: an analysis of Veterans Health Administration data. J Clin Oncol. 2015 Feb 20;33(6):567–574.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

February 20, 2015

Volume

33

Issue

6

Start / End Page

567 / 574

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Treatment Outcome
  • Survival Rate
  • Randomized Controlled Trials as Topic
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male