Delay in chemotherapy administration impacts survival in elderly patients with epithelial ovarian cancer

作者：Joseph Naima; Clark Rachel M; Dizon Don S; Lee Malinda S; Goodman Annekathryn; Boruta David Jr; Schorge John O; del Carmen Marcela G; Growdon Whitfield B^*

来源：Gynecologic Oncology, 2015, 137(3): 401-405.

DOI：10.1016/j.ygyno.2015.03.052

• Elderly
• Ovarian cancer
• Chemotherapy
• Dose delay

Objectives. The objective of this study was to characterize chemotherapy treatment patterns in elderly patients with epithelial ovarian cancer (EOC) and their impact on overall survival (OS).
Methods. We identified patients age >= 65 years with stage II-IV EOC who underwent cytoreduction from 2003 to 2011. Relevant clinical variables were extracted and correlated with OS. Statistical analyses were performed using logistic regression, Kaplan-Meier methods, and multivariable Cox proportional hazard models.
Results. One hundred and eighty-four patients were included in the analysis. The average age was 73 years with American Society of Anesthesiology Physical Status Class 2 or 3. Approximately 78% undeiwent primary debulking surgery (PDS). OS for the entire cohort was 33 years. One hundred and fifty-seven patients received adjuvant chemotherapy, of which 70% received initial platinum-based doublet therapy; 67.5% of patients were able to complete the intended six cycles of chemotherapy; of these, 34% experienced a dose reduction and 45% experienced one or more dose delays. Any dose delay was associated with a decrease in overall survival (p = 0.02) and remained significant even after controlling for age, stage, and residual disease and number of chemotherapy cycles received (p = 0.029).
Conclusions. Elderly EOC patients frequently required chemotherapy dose reductions and delays in chemotherapy administration. Multivariate analysis confirmed that dose delays are an independent factor associated with decreased OS.

• 出版日期2015-6