Abstract Background: Platinum-based doublet chemotherapy is the backbone of treatment in advanced non-small cell lung cancer (NSCLC) however second-line treatment options are controversial particularly in patients with borderline performance status (PS) of 2. The aim of this study was to compare efficacy and toxicity of weekly docetaxel versus gemcitabine in this clinical setting. Patients and methods: A total of 70 patients with advanced (stage IIIB, IV) NSCLC entered this single institute study. Cases of this study had experienced disease progression after the first-line platinum-based doublet chemotherapy, with PS 0- 2 in “Eastern Cooperative Oncology Group” scale. They were randomly assigned by stratified blocks to receive docetaxel 35 mg/m² (Arm A, n=34) or gemcitabine 1000 mg/m² (Arm B, n=36) days 1, 8 and 15, every three weeks, for up to six cycles. Primary end point was progression free survival (PFS) and secondary end points were objective response rate, disease control rate, median overall survival (OS) and toxicity. Dose modification was permitted upon clinician’s discretion for each individual patient. Results: Median of PFS was 2.02 months in arm A and 2.63 months in arm B (HR= 1.279; 95% CI: 0.710-2.304, P= 0.551). Although median OS for arm A was numerically greater (9.2 months) than arm B (8.3 months) it was statistically non-significant (HR= 1.384; 95% CI: 0.632 to 2.809, P= 0.59). Objective response was higher in Arm B than that in Arm A (P= 0.20) but disease control rates were statistically different in both arms (P= 0.034). Statistically significant differences in term of leukopenia was seen in arm B (P= 0.013). Conclusion: This study, with limited number of cases, indicates that in advanced NSCLC, weekly docetaxel and gemcitabine are reasonable second-line treatment options with statistically similar effectiveness in terms of PFS and median OS with manageable toxicities in patients with PS 0-2.
Keywords: docetaxel; gemcitabine; platinum-based doublet chemotherapy; non-small cell lung cancer

Abstract Background: Data on gastrointestinal (GI) malignancies in Ghana are relatively uncommon and are mostly on colorectal cancers. The aim of this descriptive study was to categorize gastrointestinal tract malignancies according to anatomic location and to evaluate the clinico-pathological characteristics of these malignancies. Material and methods: This was a retrospective study in the Department of Pathology from January 2002 to December 2011. Results: A total of 971 gastrointestinal (GI) malignancies were diagnosed in our institution with an annual incidence of 97.1 cases. The mean age of patients was 55.2 years (SD=16.1). The common GI malignancies were colorectal 458(47.2%), and gastric 315(32.4%) cancers. Those of the esophagus 91(9.4%), small bowel 41(4.2%), anus 47(4.8%) and the appendix 8(0.8%). The mean ages of the patients with oesophageal, gastric and large bowel cancer were 58.3 (SD=12.7), 58.39(SD=14.69), and 53.6(SD=16.0) years respectively, while those with cancers of the appendix, and small bowel were 37.6 (SD=10.9), and 44.5 years (SD=18.0). Malignancies of the colorectum 242(52.8%) and anus 26(55.3%), were common in females. The commonest malignancy of the small bowel was lymphoma 14(34.1%). A total of 38(3.8%) of the GI malignancies were gastrointestinal stromal tumours. Conclusion: The distribution of malignant tumors in the gastrointestinal tract of Ghanaians has been described and it has been found to be similar to that in western nations. The majority of patients were young. Males were the commoner victims. Many of our patients presented with late stage disease with poor prognosis.
Keywords: gastrointestinal stromal tumour; lymphoma; colorectal; gastric; esophagus; cancer