Intraperitoneal chemotherapy in older women with epithelial ovarian cancer Journal Article

  


Authors: O'cearbhaill, R.; Li, D.; Shi, W.; Thaler, H.; Sabbatini, P. J.; Konner, J.; Hensley, M. L.; Aghajanian, C. A.; Lichtman, S. M.; Tew, W. P.
Article Title: Intraperitoneal chemotherapy in older women with epithelial ovarian cancer
Abstract: Objective: Advancing age is a risk factor for survival in ovarian cancer. Gynecologic Oncology Group protocol 172 showed survival advantages and higher toxicity with intraperitoneal (IP) chemotherapy in women with optimally debulked, stage III ovarian cancer. Our objective was to explore the tolerance of IP therapy in older patients. Methods: We performed a descriptive analysis of ovarian cancer patients aged 65 years or older who had an IP catheter placed for either first-line IP chemotherapy or consolidation following intravenous (IV) carboplatin/paclitaxel. An intention-to-treat analysis of 100 ovarian cancer patients younger than 65 years was performed for comparison. Results: Between 1994 and 2008, 100 patients ≥ 65 years of age had an IP catheter inserted at our institution. Median age was 70 (range, 65-83). Median Karnofsky performance status was 90% (range, 70-90), and median number of comorbidities was 2 (range, 0-6). Twenty-four patients had first-line IP/IV cisplatin-paclitaxel, and 76 had IP cisplatin consolidation after completion of IV treatment. In the IP/IV cohort, 13 women (54%) completed all 6 planned cycles of IP therapy; 18 (75%) completed at least 4 cycles. Of all 100 patients, 13 had treatment delays, and 37 required dose reductions (21% at baseline). Median number of IP cycles was 3 (range, 0-6). There was no significant difference in the number of grade ≥ 3 toxicities between younger and older patients. Conclusions: IP chemotherapy can be safely administered in selected older patients with adequate support and dose modifications either as first-line treatment or as a consolidation therapy. Efforts to include older patients in future prospective trials should be emphasized. © 2012 Elsevier Inc.
Keywords: cancer survival; controlled study; aged; major clinical study; constipation; neutropenia; cisplatin; cancer combination chemotherapy; cancer risk; diarrhea; dose response; drug dose reduction; drug safety; paclitaxel; follow up; ovarian cancer; carboplatin; progression free survival; multiple cycle treatment; nephrotoxicity; leukopenia; thrombocytopenia; peripheral neuropathy; cancer mortality; cancer survivor; risk assessment; abdominal pain; hypomagnesemia; gastrointestinal toxicity; hyperkalemia; hypokalemia; hyponatremia; karnofsky performance status; stroke; clinical evaluation; comorbidity; ovary carcinoma; transient ischemic attack; nausea and vomiting; catheter infection; drug tolerance; geriatric patient; hearing impairment; drug administration route; intraperitoneal chemotherapy; electrolyte disturbance; iatrogenic disease; older patients; catheter occlusion; peritoneal catheter; consolidation chemotherapy
Journal Title: Journal of Geriatric Oncology
Volume: 3
Issue: 3
ISSN: 1879-4068
Publisher: Elsevier Inc.  
Date Published: 2012-01-01
Start Page: 189
End Page: 195
Language: English
DOI: 10.1016/j.jgo.2012.02.007
PROVIDER: scopus
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-84862794498&partnerID=40&md5=1ac9b95f8c92cbfd5ec382e6d9036e12
Notes: --- - "Export Date: 2 July 2012" - "Source: Scopus"
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MSK Authors
  1. Weiji Shi
    121 Shi
  2. Jason Konner
    156 Konner
  3. Paul J Sabbatini
    262 Sabbatini
  4. Stuart Lichtman
    228 Lichtman
  5. Roisin Eilish O'Cearbhaill
    272 O'Cearbhaill
  6. Martee L Hensley
    290 Hensley
  7. Carol A Aghajanian
    609 Aghajanian
  8. William P Tew
    246 Tew
  9. Howard T Thaler
    245 Thaler
  10. Daneng Li
    8 Li
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