Treatment outcome in performance status 2 advanced NSCLC patients administered platinum-based combination chemotherapy

Background: There is no consensus regarding chemotherapy to patients with advanced NSCLC (ANSCLC) and performance status (PS) 2. Using data from a national multicenter study comparing two third-generation carboplatin-based regimens in ANSCLC patients, we evaluated the outcome of PS 2 patients. Patients and methods: The 123 PS 2 patients were compared to 309 PS 0/1 patients regarding survival, quality of life (QOL) and treatment toxicity. Results: PS 2 patients had lower haemoglobin, lower global QOL and more pain, nausea/vomiting and dyspnea at inclusion. 68% of PS 2 patients received three chemotherapy courses vs. 85% in the PS 0/1 group (P < 0.01). Median and 1-year survival were lower in the PS 2 group, 4.5 vs. 8.9 months and 10% vs. 37% (P < .01). More PS 2 patients needed blood transfusions (P = 0.03) and hospitalization (P < 0.01). In contrast, PS 2 patients had better relief of pain and dyspnea, and tended to a better global QCL and did not experience more leucopoenia, infections or bleeding. Conclusions: Despite shorter survival, treatment toxicity was acceptable and PS 2 patients achieved better improvement of pain and dyspnea and tended to better global QOL when compared to PS 0/1 patients. (C) 2008 Elsevier Ireland Ltd. All rights reserved.