TITLE:
Outcomes of Quality of Life Regarding the Next-Generation Thoracoscopic Intrapleural Hyperthermic Chemotherapy of Non-Small Cell Lung Cancer with Dissemination
AUTHORS:
Takanori Ayabe, Masaki Tomita, Eiichi Chosa, Kosuke Mori, Kunihide Nakamura
KEYWORDS:
Non-Small Cell Lung Cancer, Intrapleural, Hyperthermic, Chemotherapy, Cisplatin, S-1, Quality of Life
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.1,
January
28,
2016
ABSTRACT: Background: We have developed a new next-generation intrapleural
hyperthermic chemotherapy (IPHC) for non-small cell lung cancer with
dissemination, which is a hybrid chemotherapy combined with oral S-1 medication
plus conventional cisplatin-based IPHC. We now report the preliminary
feasibility and outcome of quality of life (QOL) regarding this hybrid IPHC. Methods:
The patient was a 76-year-old male with a 2-cm nodule in the left upper lobe.
After partial resection by video-assisted thoracic surgery (VATS), which was
diagnosed with advanced pulmonary adenocarcinoma with intrapleural dissemination.
We initially performed two regimens of systemic chemotherapy, S-1 (day 1 - 21, 100
mg 2X/day) + CDDP (day 8, 60 mg/m2) and S-1 (day 1 - 14,100 mg
2X/day) + CBDCA (day 1, AUC 5). The regimen of next-generation IPHC is oral S-1
medication (day 1 - 21, 100 mg/day) + intrapleural hyperthermic perfusion of
cisplatin (200 mg/m2) with VATS (day 8,43°C, 2 hours). Adverse outcomes, QOL, and pleural
effusion were assessed in three regimens. To investigate the outcomes of the QOL,
the European Organization for Research and Treatment of Cancer QOL
Questionnaire (EORTC QLQ-C30 and QLQ-LC13), the QOL questionnaire for cancer
patients treated with anticancer drugs (QOL-ACD), the Cancer Dyspnea Score
(CDS), and the St. George’s Respiratory Questionnaire (SGRQ) were used. Results:
During the IPHC treatment course, grade 3 neutropenia, anemia, and diarrhea
were observed. The physical function after IPHC became worse compared to that
before the IPHC. Fatigue during chemotherapy (CBDCA+S-1) was more pronounced
than that during the IPHC. Nausea, vomiting, and diarrhea during the IPHC were
prevalent than those of chemotherapy. The overall QOL after the IPHC was
improved compared to that before the IPHC. Regarding before and after the IPHC,
the physical function after the IPHC became worse compared to that before the IPHC,
on the other hand, the global QOL before and after the IPHC had not dramatically
changed. Pleural effusion was controlled after the IPHC for more than 1 year. Conclusion:
The first case of a clinical trial of the next-generation IPHC showed grade 3
adverse events. However, it was an acceptable feasibility compared to the usual
platinum doublet chemotherapy. The effectiveness of the IPHC allowed the
patient to obtain a good control of the pleural effusion and preserved the
patient’s QOL.