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Retrospective analysis of the impact of platinum dose reduction and chemotherapy delays on the outcomes of stage III ovarian cancer patients.

Liutkauskiene S, Janciauskiene R, Jureniene K, Grizas S, Malonyte R, Juozaityte E - BMC Cancer (2015)

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Oncology Institute of Lithuanian University of Health Sciences, Kaunas, Lithuania. sigitaliu@yahoo.com.

ABSTRACT

Background: Ovarian 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.

Methods: Medical 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.

Results: Significant 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.

Conclusions: Chemotherapy delays in patients with FIGO stage III ovarian cancer caused lower overall survival. The most common reason for chemotherapy scheme modifications was neutropenia.

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Related in: MedlinePlus

Reasons for chemotherapy scheme modifications. Reason for every single platinum dose reduction and chemotherapy delay was established. The most common of them from most to least frequent were neutropenia, modifications with no objective medical reasons, renal disorders, anaemia, poor performance status, gastrointestinal (GI) symptoms and neuropathy.
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Fig3: Reasons for chemotherapy scheme modifications. Reason for every single platinum dose reduction and chemotherapy delay was established. The most common of them from most to least frequent were neutropenia, modifications with no objective medical reasons, renal disorders, anaemia, poor performance status, gastrointestinal (GI) symptoms and neuropathy.

Mentions: This study showed that main reasons for chemotherapy scheme modifications were the following: neutropenia (37.5%), renal disorders (15.6%), anaemia (10.9%), poor performance status (4.7%), gastrointestinal symptoms (4.7%), and neuropathy (1.6%). Modifications with no objective medical reason accounted for 25.0%. (Figure 3). When medical records contained no medical reason that could predetermine platinum dose reduction or chemotherapy delay, such modification was considered to have no objective medical reason. Considering this reason was the second most frequent among all reasons of chemotherapy scheme modifications, overall survival curve of patients who experienced modifications without objective medical reasons was compared with overall survival curve of patients who had no modifications. Using Kaplan-Meier method it was not proved that chemotherapy scheme modifications without objective medical reason caused lower overall survival compared with patients who had no chemotherapy scheme modifications, long-rank test p = 0.815. When chemotherapy scheme was modified with no objective medical reason, median progression free survival was 26.4 months (95% Cl: 16.7 - 36.2 months) and median overall survival was 51.2 months (95% Cl: 23.4 - 78.9 months).Figure 3


Retrospective analysis of the impact of platinum dose reduction and chemotherapy delays on the outcomes of stage III ovarian cancer patients.

Liutkauskiene S, Janciauskiene R, Jureniene K, Grizas S, Malonyte R, Juozaityte E - BMC Cancer (2015)

Reasons for chemotherapy scheme modifications. Reason for every single platinum dose reduction and chemotherapy delay was established. The most common of them from most to least frequent were neutropenia, modifications with no objective medical reasons, renal disorders, anaemia, poor performance status, gastrointestinal (GI) symptoms and neuropathy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4359455&req=5

Fig3: Reasons for chemotherapy scheme modifications. Reason for every single platinum dose reduction and chemotherapy delay was established. The most common of them from most to least frequent were neutropenia, modifications with no objective medical reasons, renal disorders, anaemia, poor performance status, gastrointestinal (GI) symptoms and neuropathy.
Mentions: This study showed that main reasons for chemotherapy scheme modifications were the following: neutropenia (37.5%), renal disorders (15.6%), anaemia (10.9%), poor performance status (4.7%), gastrointestinal symptoms (4.7%), and neuropathy (1.6%). Modifications with no objective medical reason accounted for 25.0%. (Figure 3). When medical records contained no medical reason that could predetermine platinum dose reduction or chemotherapy delay, such modification was considered to have no objective medical reason. Considering this reason was the second most frequent among all reasons of chemotherapy scheme modifications, overall survival curve of patients who experienced modifications without objective medical reasons was compared with overall survival curve of patients who had no modifications. Using Kaplan-Meier method it was not proved that chemotherapy scheme modifications without objective medical reason caused lower overall survival compared with patients who had no chemotherapy scheme modifications, long-rank test p = 0.815. When chemotherapy scheme was modified with no objective medical reason, median progression free survival was 26.4 months (95% Cl: 16.7 - 36.2 months) and median overall survival was 51.2 months (95% Cl: 23.4 - 78.9 months).Figure 3

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Oncology Institute of Lithuanian University of Health Sciences, Kaunas, Lithuania. sigitaliu@yahoo.com.

ABSTRACT

Background: Ovarian 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.

Methods: Medical 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.

Results: Significant 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.

Conclusions: Chemotherapy delays in patients with FIGO stage III ovarian cancer caused lower overall survival. The most common reason for chemotherapy scheme modifications was neutropenia.

Show MeSH
Related in: MedlinePlus