Feasibility of dose-dense paclitaxel/carboplatin therapy in elderly patients with ovarian, fallopian tube, or peritoneal cancer

Cancer Chemother Pharmacol. 2016 Oct;78(4):745-52. doi: 10.1007/s00280-016-3100-0. Epub 2016 Aug 13.

Abstract

Purpose: Weekly dose-dense paclitaxel (PTX) in combination with carboplatin (CBDCA) every 3 weeks (ddTC therapy) is a standard treatment for patients with advanced ovarian cancer. However, there is no detailed analysis of the feasibility of ddTC therapy in elderly patients with ovarian cancer.

Methods: We identified patients diagnosed with ovarian, fallopian tube, or peritoneal cancer who received ddTC therapy at the National Cancer Center Hospital from April 2003 to April 2013. We assessed the feasibility of ddTC therapy in elderly patients aged 70 years or older (elderly group), comparing relative dose intensity (RDI) for PTX, CBDCA, and ddTC; adverse events; and rate of chemotherapy discontinuation to those in patients below 70 years of age (younger group).

Results: A total of 143 patients (elderly group, 22; younger group, 121) was analyzed. A comparison of RDI between these two groups showed no significant differences for PTX, CBDCA, and ddTC. Nonhematological and hematological toxicity profiles of the elderly and younger groups were similar, except that severe peripheral neuropathy (Grade 2 or higher) was more common in the elderly group. There was no significant difference in the rate of chemotherapy discontinuation (elderly group, 13.6 % vs. younger group, 7.4 %, p = 0.397).

Conclusions: Our study showed that ddTC therapy was feasible for elderly patients. However, to prevent severe neuropathy, PTX dose reduction deserves consideration.

Keywords: Dose-dense paclitaxel/carboplatin; Elderly patients; Ovarian cancer; Relative dose intensity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aging
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / administration & dosage
  • Disease-Free Survival
  • Drug Administration Schedule
  • Fallopian Tube Neoplasms / drug therapy*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ovarian Neoplasms / drug therapy*
  • Paclitaxel / administration & dosage
  • Peritoneal Neoplasms / drug therapy*
  • Prognosis
  • Retrospective Studies
  • Survival Analysis

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Phytogenic
  • Carboplatin
  • Paclitaxel