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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Cancer 1/2015

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

Zeitschrift:
BMC Cancer > Ausgabe 1/2015
Autoren:
Sigita Liutkauskiene, Rasa Janciauskiene, Kristina Jureniene, Saulius Grizas, Rasa Malonyte, Elona Juozaityte
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SL conceived of the study, participated in its coordination and wrote the manuscript; EJ, RJ and SG participated in the study conception, data interpretation, developing and writing of the manuscript. KJ performed statistical analysis. RM selected cases, reviewed medical records and assisted in writing the manuscript. All authors read and approved the final manuscript.

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.
Literatur
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