Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimen
ObjectiveTo evaluate the effectiveness and safety of standard chemotherapy administered to patients >70 years with advanced ovarian cancer (OC).MethodsMedical records of 956 advanced-stage patients with OC treated between 2002-2020 with standard surgery and paclitaxel-carboplatin chemotherapy...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1289379/full |
| _version_ | 1797393036300255232 |
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| author | Miriam R. Brezis Eliya Shachar Eliya Shachar Shira Peleg Hasson Shira Peleg Hasson Ido Laskov Ido Laskov Nadav Michaan Nadav Michaan Bar Levy Ido Wolf Ido Wolf Tamar Safra Tamar Safra |
| author_facet | Miriam R. Brezis Eliya Shachar Eliya Shachar Shira Peleg Hasson Shira Peleg Hasson Ido Laskov Ido Laskov Nadav Michaan Nadav Michaan Bar Levy Ido Wolf Ido Wolf Tamar Safra Tamar Safra |
| author_sort | Miriam R. Brezis |
| collection | DOAJ |
| description | ObjectiveTo evaluate the effectiveness and safety of standard chemotherapy administered to patients >70 years with advanced ovarian cancer (OC).MethodsMedical records of 956 advanced-stage patients with OC treated between 2002-2020 with standard surgery and paclitaxel-carboplatin chemotherapy in a three-weekly (PC-3W) or weekly (PC-1W) regimen were reviewed. Treatment response and tolerability were compared between patients ≤70 years (N=723) and >70 years (N=233) with stratification to septuagenarians (>70-80 years) and octogenarians (>80 years).ResultsMedian overall survival (mOS) in patients >70 was 41.26 months (95% confidence interval [Cl], 37.22-45.14) and median progression-free survival (mPFS) was 11.04 months (95% Cl, 8.97-15.74). No statistically significant differences in mPFS and mOS were observed between septuagenarians and octogenarians. Patients >70 treated with PC-1W versus PC-3W had significantly longer mOS (57.17 versus 30.00 months) and mPFS (19.09 versus 8.15 months). Toxicity rates were mostly similar between younger and older patients. Among patients >70 treated with PC-1W, the rate of neutropenia (75.7% versus 51.8%, p=0.0005), thrombocytopenia (41.0% versus 22.2%, p=0.0042) and anemia (78.1% versus 51.9%, p<0.0001) were significantly higher and the rate of grade 2 alopecia was statistically significantly lower compared with those >70 treated with PC-3W. Significantly more patients treated with PC-1W completed ≥6 chemotherapy cycles, suggesting better tolerability of this regimen.ConclusionsOlder patients with OC may benefit from improved OS with reasonable toxicity if treated with standard chemotherapy. Older patients treated with PC-1W are more likely to complete the full chemotherapy course and survive longer compared with those treated with conventional PC-3W. |
| first_indexed | 2024-03-08T23:57:19Z |
| format | Article |
| id | doaj.art-fdc1c186302a4b198978a307a135f165 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T23:57:19Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-fdc1c186302a4b198978a307a135f1652023-12-13T04:36:05ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-12-011310.3389/fonc.2023.12893791289379Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimenMiriam R. Brezis0Eliya Shachar1Eliya Shachar2Shira Peleg Hasson3Shira Peleg Hasson4Ido Laskov5Ido Laskov6Nadav Michaan7Nadav Michaan8Bar Levy9Ido Wolf10Ido Wolf11Tamar Safra12Tamar Safra13Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelDivision of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelFaculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelFaculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelFaculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelFaculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelDivision of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelFaculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelFaculty of Medicine, Tel Aviv University, Tel Aviv, IsraelObjectiveTo evaluate the effectiveness and safety of standard chemotherapy administered to patients >70 years with advanced ovarian cancer (OC).MethodsMedical records of 956 advanced-stage patients with OC treated between 2002-2020 with standard surgery and paclitaxel-carboplatin chemotherapy in a three-weekly (PC-3W) or weekly (PC-1W) regimen were reviewed. Treatment response and tolerability were compared between patients ≤70 years (N=723) and >70 years (N=233) with stratification to septuagenarians (>70-80 years) and octogenarians (>80 years).ResultsMedian overall survival (mOS) in patients >70 was 41.26 months (95% confidence interval [Cl], 37.22-45.14) and median progression-free survival (mPFS) was 11.04 months (95% Cl, 8.97-15.74). No statistically significant differences in mPFS and mOS were observed between septuagenarians and octogenarians. Patients >70 treated with PC-1W versus PC-3W had significantly longer mOS (57.17 versus 30.00 months) and mPFS (19.09 versus 8.15 months). Toxicity rates were mostly similar between younger and older patients. Among patients >70 treated with PC-1W, the rate of neutropenia (75.7% versus 51.8%, p=0.0005), thrombocytopenia (41.0% versus 22.2%, p=0.0042) and anemia (78.1% versus 51.9%, p<0.0001) were significantly higher and the rate of grade 2 alopecia was statistically significantly lower compared with those >70 treated with PC-3W. Significantly more patients treated with PC-1W completed ≥6 chemotherapy cycles, suggesting better tolerability of this regimen.ConclusionsOlder patients with OC may benefit from improved OS with reasonable toxicity if treated with standard chemotherapy. Older patients treated with PC-1W are more likely to complete the full chemotherapy course and survive longer compared with those treated with conventional PC-3W.https://www.frontiersin.org/articles/10.3389/fonc.2023.1289379/fullolder patientsovarian cancerchemotherapysurvivaltolerabilitytoxicity |
| spellingShingle | Miriam R. Brezis Eliya Shachar Eliya Shachar Shira Peleg Hasson Shira Peleg Hasson Ido Laskov Ido Laskov Nadav Michaan Nadav Michaan Bar Levy Ido Wolf Ido Wolf Tamar Safra Tamar Safra Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimen Frontiers in Oncology older patients ovarian cancer chemotherapy survival tolerability toxicity |
| title | Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimen |
| title_full | Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimen |
| title_fullStr | Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimen |
| title_full_unstemmed | Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimen |
| title_short | Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimen |
| title_sort | effectiveness and safety of standard chemotherapy in older patients with ovarian cancer a retrospective analysis by age group and treatment regimen |
| topic | older patients ovarian cancer chemotherapy survival tolerability toxicity |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1289379/full |
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