abstract
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 - 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% underwent primary
debulking surgery (PDS). OS for the entire cohort was 3.3 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.
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