INTRODUCTION: Hematologic, gastrointestinal, and neurologic complications are common side effects of the platinum and taxane-based chemotherapy used in the primary treatment of epithelial ovarian cancer (EOC). These side effects and the impact of the resultant chemotherapy dose modification on disease free interval have not been extensively studied. The goal of this study was to determine the effect of chemotherapy delays and dose reductions on progression free survival (PFS) and overall survival (OS). METHODS: A review of patients with primary epithelial ovarian, peritoneal, and fallopian tube carcinoma treated between 1/2000 and 12/2007 was performed. Inclusion criteria were advanced stage disease and first line chemotherapy with a platinum and taxane regimen. Cox proportional hazard models were used to determine the effect of chemotherapy reductions and delays on PFS and OS. RESULTS: One hundred and fifty seven patients met the inclusion criteria. Patients were divided into four groups: no delays or reductions (48%), delay only (27%), reduction only (8%), and both delay and reduction (18%). The mean number of delays/reductions per patient was 1.1 (range=0-5) and therapy was delayed a mean of 8 days. The most common reasons for delays/reductions were neutropenia (n=51), thrombocytopenia (n=45), and neuropathy (n=18). There were no differences detected in PFS or OS between groups. CONCLUSIONS: There were no differences detected in survival between patients who required dose adjustments and treatment delays and those who did not. The lack of association between survival and chemotherapy alterations suggests that in specific circumstances patients with advanced ovarian cancer should have individualized treatment plans.
INTRODUCTION: Hematologic, gastrointestinal, and neurologic complications are common side effects of the platinum and taxane-based chemotherapy used in the primary treatment of epithelial ovarian cancer (EOC). These side effects and the impact of the resultant chemotherapy dose modification on disease free interval have not been extensively studied. The goal of this study was to determine the effect of chemotherapy delays and dose reductions on progression free survival (PFS) and overall survival (OS). METHODS: A review of patients with primary epithelial ovarian, peritoneal, and fallopian tube carcinoma treated between 1/2000 and 12/2007 was performed. Inclusion criteria were advanced stage disease and first line chemotherapy with a platinum and taxane regimen. Cox proportional hazard models were used to determine the effect of chemotherapy reductions and delays on PFS and OS. RESULTS: One hundred and fifty seven patients met the inclusion criteria. Patients were divided into four groups: no delays or reductions (48%), delay only (27%), reduction only (8%), and both delay and reduction (18%). The mean number of delays/reductions per patient was 1.1 (range=0-5) and therapy was delayed a mean of 8 days. The most common reasons for delays/reductions were neutropenia (n=51), thrombocytopenia (n=45), and neuropathy (n=18). There were no differences detected in PFS or OS between groups. CONCLUSIONS: There were no differences detected in survival between patients who required dose adjustments and treatment delays and those who did not. The lack of association between survival and chemotherapy alterations suggests that in specific circumstances patients with advanced ovarian cancer should have individualized treatment plans.
Authors: F M Muggia; P S Braly; M F Brady; G Sutton; T H Niemann; S L Lentz; R D Alvarez; P R Kucera; J M Small Journal: J Clin Oncol Date: 2000-01 Impact factor: 44.544
Authors: Robert E Bristow; Rafael S Tomacruz; Deborah K Armstrong; Edward L Trimble; F J Montz Journal: J Clin Oncol Date: 2002-03-01 Impact factor: 44.544
Authors: Edgar Ben-Josef; Jennifer Moughan; Jaffer A Ajani; Marshall Flam; Leonard Gunderson; JonDavid Pollock; Robert Myerson; Rani Anne; Seth A Rosenthal; Christopher Willett Journal: J Clin Oncol Date: 2010-10-18 Impact factor: 44.544
Authors: Robert F Ozols; Brian N Bundy; Benjamin E Greer; Jeffrey M Fowler; Daniel Clarke-Pearson; Robert A Burger; Robert S Mannel; Koen DeGeest; Ellen M Hartenbach; Rebecca Baergen Journal: J Clin Oncol Date: 2003-07-14 Impact factor: 44.544
Authors: W C Wood; D R Budman; A H Korzun; M R Cooper; J Younger; R D Hart; A Moore; J A Ellerton; L Norton; C R Ferree Journal: N Engl J Med Date: 1994-05-05 Impact factor: 91.245
Authors: Elisa V Bandera; Valerie S Lee; Lorna Rodriguez-Rodriguez; C Bethan Powell; Lawrence H Kushi Journal: JAMA Oncol Date: 2015-09 Impact factor: 31.777
Authors: Anita J Kumar; Phyllis A Gimotty; Joel M Gelfand; Georgina Buck; Jacob M Rowe; Anthony H Goldstone; Adele Fielding; David I Marks; Mark Litzow; Elisabeth Paietta; Hillard M Lazarus; Martin S Tallman; Selina M Luger; Alison W Loren Journal: Am J Hematol Date: 2016-08-22 Impact factor: 10.047
Authors: Werner Scheithauer; Ramesh K Ramanathan; Malcolm Moore; Teresa Macarulla; David Goldstein; Pascal Hammel; Volker Kunzmann; Helen Liu; Desmond McGovern; Alfredo Romano; Daniel D Von Hoff Journal: J Gastrointest Oncol Date: 2016-06
Authors: Kristen D Starbuck; J Brian Szender; William D Duncan; Kayla Morrell; John Lewis Etter; Emese Zsiros; Kunle Odunsi; Kirsten Moysich; Kevin H Eng Journal: PLoS One Date: 2018-11-12 Impact factor: 3.752