Patterns of chemotherapy treatment for women with invasive epithelial ovarian cancer - A population-based study
AuthorJordan, S.; Steer, C.; DeFazio, A.; Quinn, M.; Obermair, A.; Friedlander, M.; Francis, J.; O'Brien, S.; Goss, G.; Wyld, D.; ...
Source TitleGYNECOLOGIC ONCOLOGY
University of Melbourne Author/sQUINN, MICHAEL
AffiliationSir Peter MacCallum Department of Oncology
Document TypeJournal Article
Access StatusOpen Access
The fulltext of this publication will be made publicly available after relevant embargo periods have lapsed and associated copyright clearances obtained.
Objective. Ovarian cancer five-year survival is poor at <40%. In the absence of effective screening or new treatments, ensuring all women receive optimal treatment is one avenue to improve survival. There is little population-based information regarding the primary chemotherapy treatment that women with epithelial ovarian cancer receive. This information is essential to identify potential gaps in care.Methods. Cancer registries identified all women diagnosed with invasive epithelial ovarian cancer in Australia in 2005 (n = 1192). Histopathology, chemotherapy and comorbidity information was abstracted from medical records. Multivariable logistic regression was used to identify factors associated with chemotherapy commencement, regimen, and completion.Results. Women > 70 years (p < 0.0001), those with high-grade, stage IA/IB cancers (vs. stages IC-IV, p = 0.003) and those with mucinous cancers (p = 0.0002) were less likely to start chemotherapy. Most treated women received platinum-based drugs (97%), but only 68% received combination carboplatin-paclitaxel and only half completed six cycles without treatment modification/delay. Approximately 19% received single-agent carboplatin: mostly those aged > 70 (p<0.0001) and/or with co-morbidities (p<0.0001). Age was the strongest predictor of completing six cycles of combination therapy.Conclusions. For specific patient groups, particularly older women, there is notable variation from standard treatment. Understanding how treatment variations affect survival and determining optimal regimens for these groups are research priorities.
KeywordsChemotherapy; Ovarian cancer; Older women; Patterns of care
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