Abstract
BackgroundOvarian cancer is a common gynaecological malignancy still remaining a challenge to treat. The objective of this study was to evaluate the impact of platinum dose reduction and chemotherapy delays on progression free survival and overall survival in patients with stage III ovarian cancer and to analyze reasons for such chemotherapy scheme modifications.MethodsMedical records of patients with FIGO stage III ovarian cancer were reviewed. Inclusion criteria involved FIGO stage III epithelial ovarian carcinoma; cytoreductive surgery performed and 6 courses of platinum-based chemotherapy completed; no neoadjuvant chemotherapy applied; and no history of previous malignancies. Progression free survival and overall survival were analyzed using Kaplan-Meier and Cox proportional hazards models.ResultsSignificant 3.3 times higher death risk in patients who experienced only chemotherapy delays compared with patients who did not experience any chemotherapy scheme modifications was established (HR = 3.3, 95% Cl: 1.2 – 8.5, p = 0.016). Increased death risk in patients who experienced only chemotherapy delays compared with patients who experienced both chemotherapy delays and platinum dose reduction was also established (HR = 2.3, 95% Cl: 1.1 – 4.8, p = 0.021). Main reasons for chemotherapy scheme modifications (in decreasing order) were the following: neutropenia, modifications with no objective medical reasons, renal disorders, anaemia, poor performance status, gastrointestinal symptoms and neuropathy. Overall survival in patients who experienced chemotherapy scheme modifications with no objective medical reasons was non-inferior than in patients who did not experience any chemotherapy scheme modifications.ConclusionsChemotherapy delays in patients with FIGO stage III ovarian cancer caused lower overall survival. The most common reason for chemotherapy scheme modifications was neutropenia.
Highlights
Ovarian cancer is a common gynaecological malignancy still remaining a challenge to treat
This Cox proportional hazards model for overall survival with adjustment for patients’ age, tumor grade, histology and platinum response status revealed statistically significant overall survival difference in patients who experienced only chemotherapy delays compared with patients who did not experience neither chemotherapy delays nor platinum dose reduction, e. g., death risk was 3.3 times higher in patients who experienced only chemotherapy delays compared with patients who did not experience any modifications (HR = 3.3, 95% Cl: 1.2 – 8.5, p = 0.016)
Increased death risk in patients who experienced only chemotherapy delays compared with patients who experienced both chemotherapy delays and platinum dose reduction was established (HR = 2.3, 95% Cl: 1.1 – 4.8, p = 0.021)
Summary
Ovarian cancer is a common gynaecological malignancy still remaining a challenge to treat. Ovarian cancer is the fifth most common malignant tumor in females and the forth most common cause of female deaths from malignant tumors in the world [1]. In 2012 in Europe 65 538 new ovarian cancer cases were diagnosed and 42 704 deaths from ovarian cancer were registered. Diagnosis of ovarian cancer is still difficult due to absence of specific clinical signs or asymptomatic course of the disease advanced cancer is being diagnosed in majority of patients [3]. T. Griffths in 1975 [4] and later proved by other studies [5,6] and these findings were the cornerstone of the progress in ovarian cancer treatment.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
