Oral fluorouracil vs vinorelbine plus cisplatin as adjuvant chemotherapy for stage II-IIIA non-small cell lung cancer: Propensity score-matched and instrumental variable analyses

Cancer Medicine
Hirokazu UrushiyamaYasuhiro Yamauchi

Abstract

Adjuvant chemotherapy with vinorelbine plus cisplatin (VNR/CDDP) is a standard regimen for treatment of postoperative stage II-IIIA non-small cell lung cancer (NSCLC). However, oral fluorouracil offers a feasible alternative adjuvant chemotherapeutic regimen. We compared the prognoses of patients with NSCLC treated with adjuvant chemotherapy with either VNR/CDDP or oral fluorouracil. We identified patients with stage II-IIIA NSCLC who underwent lung surgery followed by adjuvant chemotherapy with VNR/CDDP (n = 384) or oral fluorouracil (n = 268) between July 2010 and March 2015, using the national Japanese inpatient and outpatient Diagnosis Procedure Combination database. We compared recurrence-free survival between the groups by multivariable Cox regression analysis for one-to-one propensity score-matched patients and by instrumental variable analysis. Younger patients and patients with positive N2 nodes were more likely to receive VNR/CDDP, while older patients and those with T3N0 classification were more likely to receive oral fluorouracil. Among 172 pairs of propensity-matched patients, time to adjuvant chemotherapy was shorter for oral fluorouracil compared with VNR/CDDP. Oral fluorouracil was also significantly associated ...Continue Reading

References

Apr 23, 2004·The New England Journal of Medicine·Harubumi KatoUNKNOWN Japan Lung Cancer Research Group on Postsurgical Adjuvant Chemotherapy
Jun 24, 2005·The New England Journal of Medicine·Timothy WintonUNKNOWN National Cancer Institute of the United States Intergroup JBR.10 Trial Investigators
Jun 14, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Brian E LallyLynn D Wilson
Sep 1, 2007·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Peter GoldstrawUNKNOWN Participating Institutions
Dec 23, 2009·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Jean-Yves DouillardUNKNOWN LACE Collaborative Group
May 26, 2011·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Noriyoshi SawabataUNKNOWN Japanese Joint Committee for Lung Cancer Registration
Jun 7, 2011·JAMA : the Journal of the American Medical Association·James J BiagiChristopher M Booth
Mar 7, 2014·Statistics in Medicine·Michael BaiocchiDylan S Small
Jan 21, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J MalhotraJ P Wisnivesky

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