Annals of Oncology Advance Access originally published online on November 2, 2006
Annals of Oncology 2007 18(2):256-262; doi:10.1093/annonc/mdl400
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© 2006 European Society for Medical Oncology
gynecologic tumors |
Carboplatin/cyclophosphamide or carboplatin/paclitaxel in elderly patients with advanced ovarian cancer? Analysis of two consecutive trials from the Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens
1 Medical Oncology Department, Hospices Civils de Lyon et Université de Lyon
2 Medical Oncology Department Hôtel Dieu, Paris
3 Department of Medical Information, Hospices Civils de Lyon, Lyon
4 Department of Medical Oncology, Centre Paul Papin, Angers
5 Department of Medical Oncology, Centre Alexis Vautrin, Nancy
6 Department of Medical Oncology, Clinique Rochebelle, Alès
7 Department of Medical Oncology, Centre Hospitalier, Annecy
8 Department of Medical Oncology, Centre Hospitalier, Limoges
9 Department of Medical Oncology, Centre Hospitalier Michallon, Grenoble, France
* Correspondence to: Dr G. Freyer, Medical Oncology Department, Centre Hospitalier Lyon Sud, 69495 Pierre-Bénite Cedex, France. Tel: +33-0-478864318; Fax: +33-0-478864319; E-mail: gilles.freyer{at}chu-lyon.fr
Background: To determine the feasibility of two chemotherapy regimens in elderly patients with advanced ovarian carcinoma (AOC).
Patients and methods: Eighty-three patients 
70 years were previously enrolled in a trial evaluating carboplatin and cyclophosphamide (CC). On the basis of identical eligibility criteria, 75 further patients were enrolled in a trial evaluating carboplatin and paclitaxel (Taxol) (CP). The primary end point of these studies was the feasibility of six courses of chemotherapy. Comprehensive geriatric assessment (CGA) parameters were assessed in terms of prognostic factors.
Results: More patients in the CC group presented with performance status of two or more, depression symptoms, use of co-medications, hypoalbuminemia, abnormal Mini-Mental Status score, or sub-optimal surgery. Both regimens appeared feasible: 75.6% in the CC group and 68.1% in the CP group completed six courses. CC and CP groups had similar overall survival (OS). Independent prognostic factors of poorer OS were the following: increasing age (P = 0.013), depression symptoms at baseline (P < 0.001), International Federation of Gynecology and Obstetrics stage IV (P = 0.001), and use of paclitaxel (P = 0.025).
Conclusion: As this is a non-randomised retrospective review of two consecutive studies, no firm conclusion can be drawn. It seems, however, that in elderly patients with AOC the use of paclitaxel results in more toxicity. CGA parameters and particularly emotional disorders might help to determine a priori the risk/benefit ratio of chemotherapy in this patient population.
Key words: carboplatin, comprehensive geriatric assessment, elderly, ovarian cancer, paclitaxel
Received for publication May 15, 2006. Revision received August 25, 2006. Accepted for publication September 18, 2006.
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