title: [Paclitaxel and carboplatin with or without pirarubicin (THP-ADR) as first line chemotherapy in elderly patients].
abstract: To evaluate the validity of administration of paclitaxel and carboplatin with or without pirarubicin (THP-ADR) as first line chemotherapy in elderly patients with gynecologic cancer, we explored the efficacy and safety of these regimens. From October 1, 1998 to September 30, 2001, we administered paclitaxel and carboplatin with or without THP-ADR pursuant to the chart we prepared originally as first line chemotherapy in patients with gynecologic cancer. Eleven elderly patients (age > 70 years) and 62 younger patients (age < 70 years) were entered into the present study. Paclitaxel was administered as a 3-hour intravenous (i.v.) infusion at dosages of 135 to 180 mg/m2 immediately followed by carboplatin over 60 minutes at dosages of area under the curve (AUC) 3 to 5, administered intravenously or intraperitoneally. We observed grade 3/4 anemia more frequently in elderly patients receiving the regimen including paclitaxel and carboplatin without THP-ADR (9% v.s. 47%, p < 0.0001). Grade 3/4 anemia (10% v.s. 22%, p = 0.02) and grade 3/4 thrombocytopenia (7% v.s. 22%, p = 0.007), febrile neutropenia (14% v.s. 44%, p = 0.02) also occurred more frequently in elderly patients receiving the regimen including paclitaxel and carboplatin with THP-ADR. The overall response rates were equivalent among elderly and younger patients (69% and 78%), respectively. The regimen consisting of paclitaxel and carboplatin without THP-ADR was applied safely to elderly patients.
authors.affiliation: Dept. of Obstetrics and Gynecology, Okayama University Medical School.
authors.forename: Shoji
authors.initials: S
authors.lastname: Nagao
authors.forename: Naoki
authors.initials: N
authors.lastname: Okimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hongo
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Mizutani
authors.forename: Junichi
authors.initials: J
authors.lastname: Kodama
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Yoshinouchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiramatsu
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kudo
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D016889:Endometrial Neoplasms / Q000188:drug therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D010051:Ovarian Neoplasms / Q000188:drug therapy; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D043823:Taxoids; D013921:Thrombocytopenia / Q000139:chemically induced; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy
chemical_list: D043823:Taxoids; D004317:Doxorubicin; D016190:Carboplatin; C027260:pirarubicin; D017239:Paclitaxel