Chemotherapy regimen
Docetaxel (75 mg/m2), irinotecan (100 mg/m2), pemetrexed (500 mg/m2), or paclitaxel (175 mg/m2) were given as a 1-hour infusion, followed by iv. infusion of cisplatin (70 mg/m2) for over 3 hours. Four cycles of chemotherapy were given before a tumor response assessment, as is the usual procedure at PGIMER. Before the end of the four cycles, the tumor response was assessed, and if there was undesirable toxicity or clinic-radiological symptoms of cancer development, chemotherapy was stopped if necessary. Subjects who exhibited an objective response to chemotherapy were given two more treatment cycles (i.e., maximum of 6 cycles). Response Evaluation Criteria in Solid Tumors (RECIST) criteria measure tumor response. The common toxicity criteria (CTC) version 3.0 was implemented to record and classify adverse events. PGIMER’s established procedures were used to manage any negative effects. We assessed the following hematological toxicity parameters: leukopenia, anemia, thrombocytopenia, and neutropenia. Diarrhea, nausea, and constipation were investigated for gastrointestinal toxicity. Patients with febrile neutropenia or grade 3 or higher gastrointestinal adverse effects were admitted to the hospital if outpatient treatment was not available or effective. Any other side effects from the chemotherapy were also noted. Follow-up was done every three weeks during chemotherapy and every three months for the rest of the research. Overall survival was calculated from chemotherapy to death or the last follow-up date.