title: Retrospective analysis of the impact of platinum dose reduction and chemotherapy delays on the outcomes of stage III ovarian cancer patients.
abstract: BACKGROUND
  Ovarian cancer is a common gynaecological malignancy still remaining a challenge to treat. The objective of this study was to evaluate the impact of platinum dose reduction and chemotherapy delays on progression free survival and overall survival in patients with stage III ovarian cancer and to analyze reasons for such chemotherapy scheme modifications.
  
  
  METHODS
  Medical records of patients with FIGO stage III ovarian cancer were reviewed. Inclusion criteria involved FIGO stage III epithelial ovarian carcinoma; cytoreductive surgery performed and 6 courses of platinum-based chemotherapy completed; no neoadjuvant chemotherapy applied; and no history of previous malignancies. Progression free survival and overall survival were analyzed using Kaplan-Meier and Cox proportional hazards models.
  
  
  RESULTS
  Significant 3.3 times higher death risk in patients who experienced only chemotherapy delays compared with patients who did not experience any chemotherapy scheme modifications was established (HR = 3.3, 95% Cl: 1.2 - 8.5, p = 0.016). Increased death risk in patients who experienced only chemotherapy delays compared with patients who experienced both chemotherapy delays and platinum dose reduction was also established (HR = 2.3, 95% Cl: 1.1 - 4.8, p = 0.021). Main reasons for chemotherapy scheme modifications (in decreasing order) were the following: neutropenia, modifications with no objective medical reasons, renal disorders, anaemia, poor performance status, gastrointestinal symptoms and neuropathy. Overall survival in patients who experienced chemotherapy scheme modifications with no objective medical reasons was non-inferior than in patients who did not experience any chemotherapy scheme modifications.
  
  
  CONCLUSIONS
  Chemotherapy delays in patients with FIGO stage III ovarian cancer caused lower overall survival. The most common reason for chemotherapy scheme modifications was neutropenia.
authors: Oncology Institute of Lithuanian University of Health Sciences, Kaunas, Lithuania. sigitaliu@yahoo.com.
authors: Sigita
authors: S
authors: Liutkauskiene
authors: Oncology Institute of Lithuanian University of Health Sciences, Kaunas, Lithuania. rasa.janciauskiene@kaunoklinikos.lt.
authors: Rasa
authors: R
authors: Janciauskiene
authors: Institute of Biomedical Sciences of Lithuanian University of Health Sciences, Kaunas, Lithuania. manokj@gmail.com.
authors: Kristina
authors: K
authors: Jureniene
authors: Clinic of Surgery of Lithuanian University of Health Sciences, Kaunas, Lithuania. saulius.grizas@kaunoklinikos.lt.
authors: Saulius
authors: S
authors: Grizas
authors: Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania. rasa.malonyte@gmail.com.
authors: Rasa
authors: R
authors: Malonyte
authors: Oncology Institute of Lithuanian University of Health Sciences, Kaunas, Lithuania. elona.juozaityte@kaunoklinikos.lt.
authors: Elona
authors: E
authors: Juozaityte
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D010984:Platinum / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010984:Platinum