gms | German Medical Science

Background: For the treatment of advanced non-small-cell lung cancer (NSCLC) patients with reduced performance status (ECOG PS 2) no consensus on standard treatment is defined. On the basis of current evidence, single-agent chemotherapy appears justified for patients with advanced NSCLC and PS 2. High priority should be given to the tolerability of chemotherapy and the improvement of symptomatic needs. Therefore we performed a study to examine the efficacy and tolerability of single-agent chemotherapy with Mitomycin C for patients with PS 2.

Patients and Methods: Between April 2003 and October 2004 24 chemo-naive patients (12 men and 12 women) with advanced NSCLC have been treated with 10 mg/m2 Mitomycin C at day 1 every 4 weeks until tumor progression to a maximum of six cycles. All patients presented with PS 2. Ages ranged from 53 to 83 years (mean age was 73 years).

Results: All patients received at least one cycle of chemotherapy and three patients obtained the planned 6 cycles. The mean number of cycles was 2.7. Two patients (8%) achieved a partial response and 13 patients (54%) achieved a stable disease. There were two early death (£ 4 weeks) not related to therapy. The median overall survival time was 4,7 month (95% CI: 4.42-4.9 month). No WHO grade 3/4 adverse events were observed. Six patients showed grade 1 or 2 nausea/vomiting, four patients had grade 1 or 2 fever and three showed a grade 1 or 2 thrombopenia.

Conclusion: Single-agent chemotherapy with Mitomycin is active and well tolerated for patients with reduced performance status. A high rate of disease stabilisation and response is achieved (62%) without serious adverse events. The therapy with Mitomycin offers an active and inexpensive treatment option in the palliative setting for patients with reduced PS.