Impact of Delays or Dose Reduction of Platinum-based Chemotherapy on Patients with Advanced Epithelial Ovarian Cancer
Keywords:
epithelial ovarian cancer, chemotherapy, platinumsAbstract
Platinum-based chemotherapy is the standard treatment for epithelial ovarian cancerpatients, either in early stage or in recurrent and advanced diseases. Althoughit is highly effective,
adverse effects, especially bone marrow suppression lead to delays or dose reduction of chemotherapy
which might impact on the treatment outcomes. This study aimed to discover the impacts
of platinum-base chemotherapy delay or dose reduction on treatment outcomes of patients with
advanced epithelial ovarian cancer. We did the prospective study at the outpatient’s day care
during May to September 2018. Fifty-two patients with age range from 35 to 85 years old (average
55.7 ± 10.5), were given 310 cycles of chemotherapy. There were 31 patients (59.6%) with delay of
51 doses (16.4%) of their chemotherapy. The most frequent cause of chemotherapy delay was neutropenia which found in 28 (90.4%) of patients. Eleven patients (21.1%) needed for the
chemotherapy dose reduction. Neutropenia was also the most frequent cause of the dose reduction
found at 72.7%. Patients under the age of 60 had trend of higher rate of delay chemotherapy
(69.7% vs 42.1%, P = 0.078), while no other factors associated with the chemotherapy dose
reduction. In short term assessment, delay or dose reduction of chemotherapy were not associated
with the treatment responses. Only the debulking status was associated with the treatment
responses. Only patients with complete or optimal debulking status were found response to the
treatment compare with the groups with suboptimal or inoperable diseases (100 vs 77.8 and 50.0%
respectively, P=0.003). In conclusions, delay or dose reduction of platinum-based chemotherapy
were found in more than half of the patients. The Major cause was neutropenia. However, delays
or dose reduction of the chemotherapy were not associated with the short-term treatment
responses. Patients’ survival should be monitor to evaluate the impacts on delays or dose reduction
of the chemotherapy.
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