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Annals of Oncology Advance Access originally published online on November 2, 2006
Annals of Oncology 2007 18(2):282-287; doi:10.1093/annonc/mdl401
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© 2006 European Society for Medical Oncology

gynecologic tumors

Feasibility, toxicity and quality of life of first-line chemotherapy with platinum/paclitaxel in elderly patients aged ≥70 years with advanced ovarian cancer—a study by the AGO OVAR Germany

F Hilpert1,*, A du Bois2, ER Greimel3, J Hedderich4, G Krause1, L Venhoff1, S Loibl5 and J Pfisterer1,6

1 Klinik für Gynäkologie und Geburtshilfe, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel
2 Klinik für Gynäkologie und gynäkologische Onkologie, HSK Dr Horst Schmidt Klinik, Wiesbaden, Germany
3 Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria
4 Institut für Medizinische Informatik und Statistik, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel
5 Klinik für Gynäkologie und Geburtshilfe, Klinikum der J.W. Goethe-Universität, Frankfurt/M.
6 Frauenklinik, Universitätsklinikum Mannheim, Mannheim, Germany

* Correspondence to: Dr F. Hilpert, Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Michaelisstrasse 16, D-24105 Kiel, Germany. Tel: +49-431-597-2100; Fax: +49-431-597-2146; E-mail: fhilpert{at}email.uni-kiel.de

Background: The purpose of the study was to evaluate first-line platinum/paclitaxel (Taxol) under phase III trial conditions in ovarian cancer (OC) patients aged ≥70 years.

Patients and methods: Phase III results of 779 patients with OC International Federation of Gynecology and Obstetrics (FIGO) stage IIB/IV treated with cisplatin/paclitaxel versus carboplatin/paclitaxel were retrospectively analyzed according to feasibility, toxicity (National Cancer Institute Common Toxicity Criteria) and quality of life (QoL) [European Organization for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30)] in patients aged <70 or ≥70 years.

Results: One hundred and three (13%) patients were aged ≥70 years. Patient characteristics (<70 versus ≥70 years) showed significant differences with regard to Eastern Cooperative Oncology Group performance status, residual disease and constitutional factors but not to FIGO stage, histology or grading. Elderly patients received 98%, 100% and 96% of the recommended paclitaxel, carboplatin and cisplatin dose, respectively, per cycle. Early discontinuation was more frequent in elderly, although QoL, nonhematological and hematological toxicity were comparable between elderly and younger patients, except for febrile neutropenia (5% versus <1%, P = 0.005). There were no significant differences with regard to cycle delays, dose reductions or the use of granulocyte colony-stimulating factor and antibiotics.

Conclusion: Platinum/paclitaxel appeared to be feasible and tolerable in elderly patients under clinical trial conditions, but there seems to be a different investigators' estimation of toxicity and less intention to maintain trial treatment in elderly.

Key words: elderly patients, ovarian cancer, phase III trial, platinum/paclitaxel

Received for publication June 15, 2006. Revision received September 11, 2006. Accepted for publication September 18, 2006.


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