Delays in cycles and reduction of chemotherapy dose reduce the effectiveness of treatment in patients with ovarian cancer

Authors

  • O.P. Kolesnik Zaporizhzhia Regional oncology dispancer, Zaporizhzhia, Ukraine Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
  • A.V. Kadzhoian Zaporizhzhia Regional oncology dispancer, Zaporizhzhia, Ukraine Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
  • A.O. Kabakov Zaporizhzhia Regional oncology dispancer, Zaporizhzhia, Ukraine Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
  • V.O. Kuzmenko Zaporizhzhia Regional oncology dispancer, Zaporizhzhia, Ukraine Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine

DOI:

https://doi.org/10.22141/oncology.2.1.2019.165445

Keywords:

ovarian cancer, polychemotherapy, delay in cycles, dose reduction, the effectiveness of treatment

Abstract

Every year, 205,000 new cases of ovarian cancer (OC) and 125,000 deaths from this pathology are diagnosed worldwide. The standard approach to treating patients with epithelial OC stages III–IV is primary cytoreduction with subsequent adjuvant chemotherapy or neoadjuvant chemotherapy followed by cytoreduction. Numerous studies have shown the safety and good tolerability of combined platinum-based palliative chemotherapy (PCT) in patients with OC, but in some patients, the toxicity caused by the use of chemotherapeutic agents results in delay in cycles and reduced PCT doses. In the meta-analysis conducted by Olawaiye et al. (2018), the effect of PCT dose modification on treatment outcomes in patients with OC was evaluated. In the study, in the group of patients without PCT dose modification, the median of disease-free survival was 17.5 months, whereas in patients with PCT dose modification, this indicator was 9.9 months (p = 0.001). Patients without PCT dose modification showed a statistically significant advantage in terms of the overall survival (OS) (48.0 versus 28.7 months in patients with PCT dose modification) (p = 0.021). In another study, in patients with one time delay in cycles, the median OS was 2.5 years, in women with 2 or more delays in cycles, median OS was 1.7 years (p = 0.03), while in women without dose delays, this indicator was 4.0 years (p = 0.02). The delay in PCT cycles, as well as the reduction of chemotherapy doses, are factors that can reduce the effectiveness of treatment, so the above phenomena must be avoided to ensure the effectiveness of chemotherapy for ovarian cancer.

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