Naima Joseph1, Rachel M Clark2, Don S Dizon3, Malinda S Lee4, Annekathryn Goodman5, David Boruta6, John O Schorge7, Marcela G Del Carmen8, Whitfield B Growdon9. 1. Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: njoseph11@partners.org. 2. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: rmclark@mgh.harvard.edu. 3. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: ddizon@mgh.harvard.edu. 4. Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: mlee33@partners.org. 5. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: agoodman@mgh.harvard.edu. 6. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: dboruta@mgh.harvard.edu. 7. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: jschorge@partners.org. 8. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: mdelcarmen@mgh.harvard.edu. 9. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Founders 5 Suite 546A, Boston, MA 02115, USA. Electronic address: wgrowdon@partners.org.
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 ≥65years with stage II-IV EOC who underwent cytoreduction from 2003 to 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 73years with American Society of Anesthesiology Physical Status Class 2 or 3. Approximately 78% underwent primary debulking surgery (PDS). OS for the entire cohort was 3.3years. 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.
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 ≥65years with stage II-IV EOC who underwent cytoreduction from 2003 to 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 73years with American Society of Anesthesiology Physical Status Class 2 or 3. Approximately 78% underwent primary debulking surgery (PDS). OS for the entire cohort was 3.3years. 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.
Authors: Vivian E von Gruenigen; Helen Q Huang; Jan H Beumer; Heather A Lankes; William Tew; Thomas Herzog; Arti Hurria; Robert S Mannel; Tina Rizack; Lisa M Landrum; Peter G Rose; Ritu Salani; William H Bradley; Thomas J Rutherford; Robert V Higgins; Angeles Alvarez Secord; Gini Fleming Journal: Gynecol Oncol Date: 2017-01-13 Impact factor: 5.482
Authors: Kelly L Singel; Tiffany R Emmons; Anm Nazmul H Khan; Paul C Mayor; Shichen Shen; Jerry T Wong; Kayla Morrell; Kevin H Eng; Jaron Mark; Richard B Bankert; Junko Matsuzaki; Richard C Koya; Anna M Blom; Kenneth R McLeish; Jun Qu; Sanjay Ram; Kirsten B Moysich; Scott I Abrams; Kunle Odunsi; Emese Zsiros; Brahm H Segal Journal: JCI Insight Date: 2019-03-07
Authors: Lucia Tortorella; Giuseppe Vizzielli; Domenico Fusco; William C Cho; Roberto Bernabei; Giovanni Scambia; Giuseppe Colloca Journal: Aging Dis Date: 2017-10-01 Impact factor: 6.745