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Reducing Uncertainty: Predictors of Stopping Chemotherapy Early and Shortened Survival Time in Platinum Resistant/Refractory Ovarian Cancer-The GCIG Symptom Benefit Study
University of Sydney, Australia; ANZGOG, Australia; Macarthur Cancer Therapy Centre, Australia.
Centre Francois Baclesse, France.
University of Sydney, Australia.
UCL, England.
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2017 (English)In: The Oncologist, ISSN 1083-7159, E-ISSN 1549-490X, Vol. 22, no 9, 1117-1124 p.Article in journal (Refereed) Published
Abstract [en]

Background. Clinicians and patients often overestimate the benefits of chemotherapy, and overall survival (OS), in platinum resistant/refractory ovarian cancer (PRROC). This study sought to determine aspects of health-related quality of life and clinicopathological characteristics before starting chemotherapy that were associated with stopping chemotherapy early, shortened survival, and death within 30 days of chemotherapy. Materials and Methods. This study enrolled women with PRROC before starting palliative chemotherapy. Health-related quality of life was measured with EORTC QLQ-C30/QLQ-OV28. Chemotherapy stopped within 8 weeks of starting was defined as stopping early. Logistic regression was used to assess univariable and multivariable associations with stopping chemotherapy early and death within 30 days of chemotherapy; Cox proportional hazards regression was used to assess associations with progression-free and OS. Results. Low baseline global health status (GHS), role function (RF), physical function (PF), and high abdominal/gastrointestinal symptom (AGIS) were associated with stopping chemotherapy early (all pamp;lt;.007); low PF and RF remained significant after adjusting for clinicopathological factors (both pamp;lt;.0401). Most who stopped chemotherapy early had Eastern Cooperative Oncology Group Performance Score 0-1 at baseline (79%); PF, RF, and GHS remained independently significant predictors of stopping chemotherapy early in this subgroup. Death within 30 days of chemotherapy occurred in 14%. Low-GHS, RF, and PF remained significantly associated with death within 30 days of chemotherapy after adjusting for clinicopathological factors (all pamp;lt;.012). Conclusion. Women with low GHS, RF, or PF before starting chemotherapy were more likely to stop chemotherapy early, with short OS. Self-ratings of GHS, RF, and PF could improve patient-clinician communication regarding prognosis and help decision-making in women considering chemotherapy for PRROC.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 22, no 9, 1117-1124 p.
Keyword [en]
Patient-reported outcomes; Prognosis; Platinum-resistant ovarian cancer; Quality of life
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-141729DOI: 10.1634/theoncologist.2017-0047ISI: 000410656500017PubMedID: 28596446OAI: oai:DiVA.org:liu-141729DiVA: diva2:1147300
Note

Funding Agencies|Australian National Health and Medical Research Council [GNT1063012]; Target Ovarian Cancer; Cancer Research U.K.; UCL Cancer Trials Centre [C444/A15953]; Department of Health

Available from: 2017-10-05 Created: 2017-10-05 Last updated: 2017-10-05

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Åvall Lundqvist, Elisabeth
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health Sciences
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CiteExportLink to record
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