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. 2017 Mar;144(3):459-467.
doi: 10.1016/j.ygyno.2016.11.033. Epub 2017 Jan 13.

Chemotherapy completion in elderly women with ovarian, primary peritoneal or fallopian tube cancer - An NRG oncology/Gynecologic Oncology Group study

Vivian E von Gruenigen  1 , Helen Q Huang  2 , Jan H Beumer  3 , Heather A Lankes  4 , William Tew  5 , Thomas Herzog  6 , Arti Hurria  7 , Robert S Mannel  8 , Tina Rizack  9 , Lisa M Landrum  10 , Peter G Rose  11 , Ritu Salani  12 , William H Bradley  13 , Thomas J Rutherford  14 , Robert V Higgins  15 , Angeles Alvarez Secord  16 , Gini Fleming  17
Affiliations

Chemotherapy completion in elderly women with ovarian, primary peritoneal or fallopian tube cancer - An NRG oncology/Gynecologic Oncology Group study

Vivian E von Gruenigen et al. Gynecol Oncol. 2017 Mar.

Abstract

Purpose: A simple measure to predict chemotherapy tolerance in elderly patients would be useful. We prospectively tested the association of baseline Instrumental Activities of Daily Living (IADL) score with ability to complete 4 cycles of first line chemotherapy without dose reductions or >7days delay in elderly ovarian cancer patients.

Patients and methods: Patients' age ≥70 along with their physicians chose between two regimens: CP (Carboplatin AUC 5, Paclitaxel 135mg/m2) or C (Carboplatin AUC 5), both given every 3weeks either after primary surgery or as neoadjuvant chemotherapy (NACT) with IADL and quality of life assessments performed at baseline, pre-cycle 3, and post-cycle 4.

Results: Two-hundred-twelve women were enrolled, 152 selecting CP and 60 selecting C. Those who selected CP had higher baseline IADL scores (p<0.001). After adjusting for age and PS, baseline IADL was independently associated with the choice of regimen (p=0.035). The baseline IADL score was not found to be associated with completion of 4 cycles of chemotherapy without dose reduction or delays (p=0.21), but was associated with completion of 4 cycles of chemotherapy regardless of dose reduction and delay (p=0.008) and toxicity, with the odds ratio (OR) of grade 3+ toxicity decreasing 17% (OR: 0.83; 95%CI: 0.72-0.96; p=0.013) for each additional activity in which the patient was independent. After adjustment for chemotherapy regimen, IADL was also associated with overall survival (p=0.019) for patients receiving CP.

Conclusion: Patients with a higher baseline IADL score (more independent) were more likely to complete 4 cycles of chemotherapy and less likely to experience grade 3 or higher toxicity.

Keywords: Chemotherapy; Elderly women; Ovarian cancer.

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Conflict of interest statement

CONFLICTS OF INTEREST

All other co-authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Completion status of four cycles of chemotherapy. Carboplatin Paclitaxel = CP, Carboplatin =P. Numbers equal %
Figure 2
Figure 2
Subgroup analysis of the association between other geriatric measures and tolerance of chemotherapy. Independent activities of daily living (IADL), activities of daily living (ADL), The Functional Assessment of Cancer Therapy — Ovary (FACT–O), body mass index (BMI).
Figure 3
Figure 3
Subgroup analysis of the association between geriatric measures and four cycles of chemotherapy regardless of dose reduction or treatment delay.
Figure 4
Figure 4
Patient reported PROs over Time by chemotherapy. Independent activities of daily living (IADL), activities of daily living (ADL), The Functional Assessment of Cancer Therapy — Ovary (FACT–O), Functional Assessment of Cancer Treatment — Neurotoxicity -FACT/GOG-Ntx 4 subscale
Figure 5
Figure 5
Overall Survival by number of Independent Instrumental Activities. Carboplatin Paclitaxel = CP, Carboplatin =P
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References

    1. Tew WP, Muss HB, Kimmick GG, von Gruenigen VE, Lichtman SM. Breast and ovarian cancer in the older woman. J Clin Oncol. 2014;32:2553–2561. - PubMed
    1. Joseph N, Clark RM, Dizon DS, Lee MS, Goodman A, Boruta D, Jr, et al. Delay in chemotherapy administration impacts survival in elderly patients with epithelial ovarian cancer. Gynecol Oncol. 2015;137:401–405. - PubMed
    1. Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen ML, Extermann M, Falandry C, Artz A, Brain E, Colloca G, Flamaing J, Karnakis T, Kenis C, Audisio RA, Mohile S, Repetto L, Van Leeuwen B, Milisen K, Hurria A. International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol. 2014;32(24):2595–603. - PMC - PubMed
    1. Deshpande PR, Rajan S, Lakshmi Sudeepthi B, Abdul Nazir CP. Patient-reported outcomes: A new era in clinical research. Perspect Clin Res. 2011;2(4):137–144. - PMC - PubMed
    1. Basen-Engquist K, Bodurka-Bevers D, Fitzgerald MA, Webster K, Cella D, Hu S, et al. Reliability and validity of the functional assessment of cancer therapy-ovarian. J Clin Oncol. 2001;19:1809–1817. - PubMed

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