Comparison of older and younger patients with ovarian cancer: A post hoc study ( <scp>JGOG3016‐A3</scp> ) of the treatment strength and prognostic outcomes of conventional or dose‐dense chemotherapy
Comparison of older and younger patients with ovarian cancer: A post hoc study ( <scp>JGOG3016‐A3</scp> ) of the treatment strength and prognostic outcomes of conventional or dose‐dense chemotherapy
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老年和年轻卵巢癌患者的比较：常规或剂量密集化疗的治疗强度和预后结果的事后研究 (<scp>JGOG3016-A3</scp>)
DOI：
10.1111/jog.15620
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发表时间：
2023
影响因子：
1.6
通讯作者：
Enomoto Takayuki
中科院分区：
文献类型：
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作者：
Itani Yoshio;Sakai Hitomi;Hamano Tetsutaro;Asai‐Sato Mikiko;Futagami Masayuki;Fujimura Masaki;Aoki Yoichi;Suzuki Nao;Yoshida Yoshio;Enomoto Takayuki
Aimto评估治疗强度的变化及其对老年卵巢癌患者预后的影响。方法我们回顾性比较了老年（≥65岁）和年轻（<65岁）患者的相对剂量强度（RDI）作为治疗强度、预后和其他特征的代表。分析了日本妇科肿瘤组（JGOG）3016临床试验中301例接受剂量密集型紫杉醇-卡铂（dTC）治疗的77例老年患者和304例接受常规紫杉醇-卡铂（cTC）治疗的93例老年患者。（87.4%vs.90.8%，p = 0.009），但dTC中无（79.0%vs.81.2%，p = 0.205）。在两种治疗方案中，老年患者的总生存期均低于年轻患者：dTC的风险比[HR] = 1.80; 95%置信区间[CI]：1.25-2.59;p= 0.001; cTC的风险比[HR]= 1.59; 95% CI：1.15-2.19;p= 0.04。然而，RDI在统计学上未被确定为预后因素。通过多变量分析确定的两种治疗方案的预后因素为临床分期和残留疾病; dTC为年龄、体能状态和血清白蛋白; cTC为白色血细胞计数。有没有不同的年龄组之间观察到的中性粒细胞减少症在任一regiment.ConclusionsThe RDI的老年患者根据管理的时间表，并不总是低于年轻的患者。dTC组中治疗强度与年轻患者相当的老年患者的预后水平与年轻患者不同。其他生物因素可归因于老化可能影响预后。
AimTo evaluate changes of treatment strength and its impact on prognosis in older patients with ovarian cancer.MethodsWe compared relative dose intensity (RDI) as a representative of treatment strength, prognosis, and other features between older (≥65 years) and younger patients (<65 years) retrospectively. Seventy‐seven older patients of 301 who received dose‐dense‐paclitaxel‐carboplatin (dTC) and 93 older patients of 304 who received conventional‐paclitaxel‐carboplatin (cTC) from the Japanese Gynecologic Oncology Group (JGOG) 3016 clinical trial were analyzed.ResultsThe RDI of older patients was lower than that of younger patients in cTC (87.4% vs. 90.8%,p= 0.009) but not in dTC (79.0% vs. 81.2%,p= 0.205). In both regimens, older patients had worse overall survival than younger patients: hazard ratio [HR] = 1.80; 95% confidence interval [CI]: 1.25–2.59;p= 0.001 for dTC, and HR = 1.59; 95% CI: 1.15–2.19;p= 0.04 for cTC. However, the RDI was not determined as a prognostic factor statistically. The prognostic factors identified by multivariate analysis for both regimens were clinical stage and residual disease; for dTC were age, performance status, and serum albumin; and for cTC was white blood cell count. There was no difference in neutropenia observed between age groups in either regimen.ConclusionsThe RDI of older patients varies according to the administered schedule and is not always lower than that of younger patients. Older patients with comparable treatment strength to younger patients in the dTC group did not accomplish the same level of prognosis as younger patients. Other biologic factors attributable to aging may affect prognosis.