Background: Small cell lung cancer accounts for 15% of all lung cancer approximately. Etoposide-Cisplatin combination is the established standard regimen of choice. Irinotecan, a topoisomerase inhibitor is effective against small cell lung cancer. Several studies showed the superiority of Irinotecan-Cisplatin regimen combination over Etoposide-Cisplatin regimen.

Aims and Objectives:To compare the response and toxicities of Etoposide-Cisplatin regimen with Irinotecan-Cisplatin in the treatment of Extensive Stage Small cell lung cancer.

Material and Method: Quasi-experimental study was conducted from May 2019 to April 2020 in various center of Bangladesh. 64 patients (32 patients on each Arm) who met the inclusion criteria of the study were enrolled. Arm A received Irinotecan 60mg/m2 on day 1, 8,15 plus Cisplatin 60 mg/m2 on day 1 every 4 weeks for 6 cycles. In another arm, Etoposide (80mg/m2 IV on day 1-3) plus Cisplatin (80 mg/m2 IV on day 1) every 3 weekly for 6 cycles was given. Each patient was evaluated before, during and after the completion of the treatment. The follow up was done at 6 and 12 weeks after the completion of the treatment.

Result: The overall mean age was 56.84 ± 9.01 within the age range of 34-70 years. Overall, cough 54 (84.38%) followed by dyspnea 28(77.78%) was the most common presentation. Both outcome and toxicities were evaluated. Regarding the tumor control there was no statistically significant difference in both arms at 6 weeks (p = 0.76) and 12 weeks (p = 0.74) of follow-up. Grade ≥2 anaemia was common in Arm B than Arm A 22 (68.75%) vs 16 (50%)), p = 0.28. Grade 3 neutropenia was seen in 04 (12.5%) patients of the Arm A and 08 (25%) patients of Arm B, p = 0.26. The highest grade of nausea and vomiting (grade 3) was seen in 05 (15.6%) patients of Arm A and 03 (9.4%) patients of Arm B, p = 0.46. Significant grade ≥1 diarrhoea was 30 (93.7%) in Arm A and 6 (18.8%) in Arm B, p = <0.001. 09 (28.125%) patients from Arm A and 15 (46.9%) patients from Arm B developed febrile neutropenia, p = 0.21. Grade ≥1 Alopecia 28 (84.4%) in Arm b and 04 (12.5%) in Arm, p = <0.001.

Conclusion: This study supports the fact that Irinotecan-Cisplatin based chemotherapy schedule is not inferior and almost equally effective to Etoposide-Cisplatin based chemotherapy regimen.

Keywords: Lung Cancer; Etoposide-Cisplatin; Irinotecan-Cisplatin Regimen

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Citation

Citation: Md Fazle Robbi., et al. “Evaluation of Response and Toxicities of Irinotecan-Cisplatin Versus Etoposide-Cisplatin in Extensive Stage Small Cell Lung Cancer”.Acta Scientific Cancer Biology 8.8 (2024): 08-18.

Copyright

Copyright: © 2024 Nkoua Epala Brice Aymard., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.