[Docetaxel in combination with cisplatin for first-line treatment of locally advanced or metastatic non-small cell lung cancer: meta-analysis of randomized and controlled clinical trials].

Background and Objective: Recent approval of docetaxel in combination with cisplatin (DP) for non-small cell lung cancer (NSCLC) treatment means that an assessment of its effectiveness and toxicity is necessary. The aim of this study was to evaluate docetaxel/cisplatin combination versus other cisplatin-based regimens as the front-line treatment of metastatic or locally advanced NSCLC.
Material and Method: We searched randomized and controlled phase III clinical trials comparing DP versus other cisplatin combinations. Patients had to be diagnosed of advanced NSCLC and had not previously received chemotherapy.A meta-analysis was performed using the Mantel-Haenzel method. Antitumoral activity and adverse events were both evaluated. We also made a heterogeneity test and determined the NNT Index (Number Needed to Treat) for two-year survival.
Results: We found three clinical trials that fulfilled our criteria. Results showed significant enhanced two-year survival for DP (11-47% higher than others), but a greater incidence of diarrhea (odds ratio [OR] = 2.525; confidence interval 95% [CI], 1.697-3.756]). Heterogeneity was significant for response, anemia and thrombopenia. NNT was 17 patients for two-year survival.
Conclusions: DP is a good option in first-line therapy of advanced NSCLC. The two-year survival is significantly longer and its toxic profile similar to other treatments, except for diarrhea.