Comparison of older and younger patients with ovarian cancer: A post hoc study (JGOG3016-A3) of the treatment strength and prognostic outcomes of conventional or dose-dense chemotherapy.

Autor: Itani Y; Yao Municipal Hospital Palliative Care Center, Yao-Shi, Japan., Sakai H; Advanced Cancer Translational Research Institute (ACT), Showa University, Tokyo, Japan., Hamano T; P4 Statistics Co. Ltd., Setagayaku, Japan., Asai-Sato M; Department of Obstetrics and Gynecology, Nihon University School of Medicine, Itabashiku, Japan., Futagami M; Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan., Fujimura M; Tokyo Medical University Ibaraki Medical Center, Inashikigun, Japan., Aoki Y; University of the Ryukyus, Okinawa, Japan., Suzuki N; St. Marianna University School of Medicine Hospital, Kawasaki, Japan., Yoshida Y; University of Fukui Hospital, Fukui, Japan., Enomoto T; Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Jazyk: angličtina
Zdroj: The journal of obstetrics and gynaecology research [J Obstet Gynaecol Res] 2023 May; Vol. 49 (5), pp. 1400-1411. Date of Electronic Publication: 2023 Mar 01.
DOI: 10.1111/jog.15620
Abstrakt: Aim: To evaluate changes of treatment strength and its impact on prognosis in older patients with ovarian cancer.
Methods: We compared relative dose intensity (RDI) as a representative of treatment strength, prognosis, and other features between older (≥65 years) and younger patients (<65 years) retrospectively. Seventy-seven older patients of 301 who received dose-dense-paclitaxel-carboplatin (dTC) and 93 older patients of 304 who received conventional-paclitaxel-carboplatin (cTC) from the Japanese Gynecologic Oncology Group (JGOG) 3016 clinical trial were analyzed.
Results: The RDI of older patients was lower than that of younger patients in cTC (87.4% vs. 90.8%, p = 0.009) but not in dTC (79.0% vs. 81.2%, p = 0.205). In both regimens, older patients had worse overall survival than younger patients: hazard ratio [HR] = 1.80; 95% confidence interval [CI]: 1.25-2.59; p = 0.001 for dTC, and HR = 1.59; 95% CI: 1.15-2.19; p = 0.04 for cTC. However, the RDI was not determined as a prognostic factor statistically. The prognostic factors identified by multivariate analysis for both regimens were clinical stage and residual disease; for dTC were age, performance status, and serum albumin; and for cTC was white blood cell count. There was no difference in neutropenia observed between age groups in either regimen.
Conclusions: The RDI of older patients varies according to the administered schedule and is not always lower than that of younger patients. Older patients with comparable treatment strength to younger patients in the dTC group did not accomplish the same level of prognosis as younger patients. Other biologic factors attributable to aging may affect prognosis.
(© 2023 Japan Society of Obstetrics and Gynecology.)
Databáze: MEDLINE
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