title: Patterns of chemotherapy treatment for women with invasive epithelial ovarian cancer--a population-based study.
abstract: OBJECTIVE
  Ovarian cancer five-year survival is poor at <40%. In the absence of effective screening or new treatments, ensuring all women receive optimal treatment is one avenue to improve survival. There is little population-based information regarding the primary chemotherapy treatment that women with epithelial ovarian cancer receive. This information is essential to identify potential gaps in care.
  
  
  METHODS
  Cancer registries identified all women diagnosed with invasive epithelial ovarian cancer in Australia in 2005 (n=1192). Histopathology, chemotherapy and comorbidity information was abstracted from medical records. Multivariable logistic regression was used to identify factors associated with chemotherapy commencement, regimen, and completion.
  
  
  RESULTS
  Women >70 years (p<0.0001), those with high-grade, stage IA/IB cancers (vs. stages IC-IV, p=0.003) and those with mucinous cancers (p=0.0002) were less likely to start chemotherapy. Most treated women received platinum-based drugs (97%), but only 68% received combination carboplatin-paclitaxel and only half completed six cycles without treatment modification/delay. Approximately 19% received single-agent carboplatin: mostly those aged >70 (p<0.0001) and/or with co-morbidities (p<0.0001). Age was the strongest predictor of completing six cycles of combination therapy.
  
  
  CONCLUSIONS
  For specific patient groups, particularly older women, there is notable variation from standard treatment. Understanding how treatment variations affect survival and determining optimal regimens for these groups are research priorities.
authors: Gynaecological Cancers Group, The Population Health Department, The Queensland Institute of Medical Research, Brisbane, Queensland, Australia. susan.jordan@qimr.edu.au
authors: S
authors: S
authors: Jordan
authors: C
authors: C
authors: Steer
authors: A
authors: A
authors: DeFazio
authors: M
authors: M
authors: Quinn
authors: A
authors: A
authors: Obermair
authors: M
authors: M
authors: Friedlander
authors: J
authors: J
authors: Francis
authors: S
authors: S
authors: O'Brien
authors: G
authors: G
authors: Goss
authors: D
authors: D
authors: Wyld
authors: Australian Ovarian Cancer Study Group
authors: P
authors: P
authors: Webb
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001315:Australia; D016190:Carboplatin / Q000008:administration & dosage; D000077216:Carcinoma, Ovarian Epithelial; D004334:Drug Administration Schedule; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012042:Registries
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel