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abstract (NOGGO)
June 2016
Elderly ovarian cancer patients: An individual participant data meta-analysis of the North-Eastern German Society of Gynecological Oncology (NOGGO)
Highlights
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- Cardiovascular disease and diabetes are more frequent in the elderly.
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- There was no difference between both age groups concerning polypharmacy.
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- Haematological toxicity was more frequent in the elderly, while chemotherapy was not discontinued earlier than planned.
Background
Barriers
for optimal treatment and enrolment in clinical trials are the
physicians' perceptions towards age, comorbidities and fear of toxicity
as well as the eligibility criteria of clinical trials. There is a high
need to gain more knowledge about this patient group in order to
optimize treatment. We aimed to evaluate the influence of age above 65
years on comorbidities, comedication, grade III/IV toxicity, prior
discontinuation of chemotherapy and survival.
Patients and methods
An
individual participant data meta-analysis of three phase II/III studies
(‘Tower’, ‘Topotecan phase III’ and ‘Hector’) of the North-Eastern
German Society of Gynecological Oncology including 1213 patients with
recurrent ovarian cancer was conducted using logistic regression and Cox
regression analysis.
Results
Median
age at diagnosis was 59 years. The patient group ≥65 years included
349 versus 864 patients younger than 65 years. Cardiovascular disease
and diabetes were more frequent in the older age group. Haematological and cardiovascular grade III/IV toxicities
were more often seen in patients above 65 years, while
non-haematological toxicity was not.... There was no
difference in prior discontinuation of treatment in multivariate
analysis. Cox regression showed a trend towards poorer progression-free
survival in the older age group.
Conclusion
Haematological
and cardiovascular toxicities are more frequent in elderly patients.
However, this did not influence prior discontinuation of therapy.
Elderly patients should not be deprived of adequate chemotherapy or
excluded from clinical studies just because of their age. Thorough
geriatric assessment and monitoring is mandatory.
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