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

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

von Gruenigen Vivian E; Huang Helen Q; Beumer Jan H; Lankes Heather A; Tew William; Herzog Thomas; Hurria Arti; Mannel Robert S; Rizack Tina; Landrum Lisa M; Rose Peter G; Salani Ritu; Bradley William H; Rutherford Thomas J; Higgins Robert V; Secord Angeles Alvarez; Fleming Gini

Gynecologic oncology

2017

2017-03

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 \textgreater7days delay in elderly ovarian cancer patients. PATIENTS AND METHODS: Patients' age \textgreater/=70 along with their physicians chose between two regimens: CP (Carboplatin AUC 5, Paclitaxel 135mg/m(2)) 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\textless0.001). 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.

*Chemotherapy; *Elderly women; *Ovarian cancer; 80 and over; Age Factors; Aged; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use; Fallopian Tube Neoplasms/*drug therapy/pathology; Female; Humans; Ovarian Neoplasms/*drug therapy/pathology; Peritoneal Neoplasms/*drug therapy/pathology

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

459–467

3

144