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The impact of age on first-line chemotherapy treatment of epithelial ovarian cancer and primary peritoneal carcinoma

Larbi, E, Madhuri, TK, Essapen, S and Michael, A The impact of age on first-line chemotherapy treatment of epithelial ovarian cancer and primary peritoneal carcinoma In: ASCO, 2010-06-03 - 2010-06-07, Chicago USA.

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Background: Standard treatment for epithelial ovarian (EOC) and primary peritoneal (PP) cancer is combination of surgery and chemotherapy. Most commonly used first-line drugs are carboplatin and paclitaxel (C/P). Treatment decisions involving elderly patients are complex and single agent carboplatin (C) is often preferred. To help the decision process we analysed the toxicity profile and outcome for elderly patients treated first line with both: C/P and C alone. Methods: A retrospective analysis of 82 elderly patients (> 75 years) treated for EOC and PP cancer between April 1996 and October 2009 was performed. Age, comorbidities, CA-125 at diagnosis, histology, stage, outcome of cytoreductive surgery (CRS), chemotherapy regimen, toxicity and clinical response were recorded. Results: The majority, 76% (63/82) of patients had serous ovarian cancer with 58.5% presenting as FIGO stage 3c, median CA-125 of 340.2 U/mL (range: 5-5702). 67.1% (55/82) had CRS with 61.9% (34) optimally debulked. 84.2% of patients (69/82) received chemotherapy and were therefore evaluable for the purpose of this analysis. 94.2% (65/69) completed treatment (mean number of cycles = 5.1). 35.4% (23/65) received C/P and 63.1% (41/65) received single agent C. The commonest complication was peripheral neuropathy- 56.5% (13/23) in combination arm. Treatment was deferred mainly due to haematological toxicity: neutropaenia - 13.9% (6/43) in the C arm and 11.1% (3/27) in C/P; grade 3/4 thrombocytopaenia-4 (3-C, 1-P/C); grade 3-anaemia-1 (C). Dose reduction was required for 46.1% (12/26) in the combination arm and 25.5% (11/43) in the C arm. There were 35 dose delays-34.6% (9/26) C/P and 60.4% (26/43) C. Median survival for this group of patients was 21.3months. Median PFS was 8.8 months in C/P arm and 7 months in the C arm (95% CI-0.71 to1.8-not statistically significant). Conclusions: The toxicity of combination treatment with C/P is comparable to single agent C in elderly population with frequent dose delays and dose reductions. Initial assessment of comorbidities and performance status is essential however effort should be made to offer patients optimal treatment with the combination regimen.

Item Type: Conference or Workshop Item (UNSPECIFIED)
Divisions : Surrey research (other units)
Authors :
Larbi, E
Madhuri, TK
Essapen, S
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 09:38
Last Modified : 23 Jan 2020 15:41

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