Decreased dose density of standard chemotherapy does not compromise survival for ovarian cancer patients. Issue 1 (1st January 2008)

• Record Type: Journal Article
• Authors: Molckovsky, A.; Vijay, S. M.; Hopman, W. M.; Bryson, P.; Jeffrey, J. F.; Biagi, J. J.
• Is Part Of: International journal of gynecological cancer. Volume 18:Issue 1(2008)
• Page Start: 8
• Page End: 13
• Publication Date: 2008-01-01
• Subjects: carboplatin -- chemotherapy -- dose density -- ovarian neoplasm -- paclitaxel; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-00009577-200801000-00002
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : For women diagnosed with ovarian cancer, the standard practice of surgery followed by adjuvant platinum–taxane combination chemotherapy, with cycles administered every 3 weeks, is based on randomized control trials. However, a substantial number of patients require delays or reductions on this schedule. The Cancer Centre of Southeastern Ontario (CCSEO) has historically administered chemotherapy every 4 weeks. We analyzed survival outcomes of our cohort. All ovarian cancer patients treated with chemotherapy at the CCSEO from 1995 to end-2002 were included in this study. Overall survival and progression-free survival were calculated from initiation of chemotherapy using the Kaplan–Meier technique and log-rank tests. Cox regression analysis was used to adjust for age and disease stage. A total of 171 patients were treated with chemotherapy (cisplatin–paclitaxel or carboplatin–paclitaxel), of which 144 received chemotherapy every 4 weeks and 27 every 3 weeks. Median progression-free survival was 19.2 months for the group treated every 4 weeks vs 13.2 months for the 3-weekly group. Median overall survival was 36.5 months compared to 27.1 months, respectively. Trends favored treatment every 4 weeks. In early-stage disease, 5-year overall survival was 74% and 5-year progression-free survival was 68%. Administration of platinum–paclitaxel chemotherapy every 4 weeks did not reduce survival of ovarian cancer patients. Importantly, median survival is favorable compared to results from landmark trials where patients were treated every 3 weeks. These results suggest that decreasing the frequency of chemotherapy cycles does not decrease survival. Prospective trials would be required to compare quality of life and cost-effectiveness.