A comparison of monthly symptom reports for older (≥ 70 years) versus younger (< 70 years) women with recurrent ovarian cancer over 1 year.

Abstract

85 Background: Approximately 30% of ovarian cancer patients are 70 or older at diagnosis. Evidence to guide treatment in this age group is limited in the recurrent setting due to clinician concerns about toxicities and quality of life. Evidence based on patient-reported outcomes is scarce. The objective of this exploratory analysis is to compare patient-reported symptoms for women with recurrent ovarian cancer > age 70 vs. < age 70. Methods: Ancillary analysis of data from a 3-arm web-based symptom management RCT (NR010735; GOG-259). Eligibility criteria included recurrent or persistent ovarian, fallopian, or primary peritoneal cancer; experiencing 3 or more cancer or treatment-related symptoms. 497 women were accrued; of those, 60 (12%) were > age 70. Monthly severity data for 11 cancer- and treatment-symptoms rated “at their worst in the past week” on a 0 to 10 Likert-type scale are included in this analysis. Time (linear, quadratic, and cubic), age (young vs. old), and time by age group interactions were evaluated using random coefficient modeling for each of the symptoms over 12 months. Results: In general, the severity of these selected symptoms declined significantly (p < .05) either linearly (memory problems and anxiety) or nonlinearly (fatigue, pain, constipation, peripheral neuropathy, nausea, lack of appetite, depression, and sleep disturbances) over time, except for vomiting which did not demonstrate a significant change over time. Age effects or age by time interactions (significant, p < .05, or a trend, .05 < = p < .10) were found for pain, constipation, peripheral neuropathy, vomiting, and sleep disturbances, with generally higher initial values for younger ( < = 70 years) women for pain and sleep disturbances and higher overall means for younger women for vomiting. For constipation and peripheral neuropathy, the nonlinear change over time varied significantly by age group, with the decline over time being more precipitous for older women. Conclusions: A better understanding of the different propensity for symptoms based on age can help clinicians not only address them but also choose chemotherapies to minimize them.