e18034 Background: Platinum-based cytotoxic chemotherapy remains the standard first-line therapy for patients with lung squamous cell carcinoma. This study aims to compare the effectiveness of first-line platinum-based chemotherapy regimens for advanced lung squamous cell carcinoma in the general population in Taiwan. Methods: We searched the Taiwan Cancer Registry database and the claim database of National Health Insurance, Taiwan for patients with newly diagnosed advanced lung squamous cell carcinoma from 2004 to 2007. Patients who received first-line combination chemotherapy with a platinum compound (cisplatin or carboplatin) plus either gemcitabine (G), docetaxel (D), paclitaxel (T), or vinorelbine (V) were included in the study. Overall survival (OS) was defined as the duration from the start of chemotherapy to death. Kaplan-Meier method was used to estimate the survival, which was univariately compared by the log-rank test. The Cox’s proportional hazard model was used to estimate the adjusted hazard ratios in multivariate analyses. Results: A total of 935 patients with advanced lung squamous cell carcinoma received first-line chemotherapy with a platinum compound (P) plus either G (57.6%), D (14.9%), T (11.3%), or V (16.0%). The proportion of elderly patients (age ≥ 70) who received P+D is lower than that of P+G, P+T, or P+V (35.71% vs 47.68%, 53.77%, 48.00% respectively, p = 0.0264). Patients who received P+G, P+D, P+T, or P+V had similar OS (median, 8.6 vs. 7.9 vs. 8.8 vs. 8.1 months, respectively; p = 0.969). Subgroup analyses based on age (≥ 70 or < 70), gender, stage (IIIB or IV by AJCC 6th edition), and the use of cisplatin revealed no differences in OS, either. In multivariate analyses adjusting for age, gender, and stage, the first-line chemotherapy regimen was still not a predictor of OS. With P+G as the reference group, the adjusted hazard ratios of P+D, P+T, and P+V were 1.02, 0.96, 1.03, respectively (p = 0.945). Conclusions: In patients with advanced lung squamous cell carcinoma, different treatment regimens did not have significant impact on the survival outcomes
Development and validation of a prognostic index for efficacy evaluation and prognosis of first-line chemotherapy in stage III–IV lung squamous cell carcinoma