title: Adherence to Hematologic Hold Parameters in Carboplatin and Dose-Dense Paclitaxel Chemotherapy for Ovarian Malignancies: A Survey of NCCN Member Institutions.
abstract: To determine the adherence to hematologic chemotherapy hold parameters for the carboplatin and dose-dense paclitaxel chemotherapy regimen in patients with ovarian, fallopian tube, or primary peritoneal cancers.
  
  
  
  This is a quality assessment survey study. All 26 NCCN Member Institutions were contacted electronically. Hematologic chemotherapy hold parameter values (absolute neutrophil count [ANC] and platelet count) on days 1, 8, and 15 of each cycle were queried. These hold parameters were compared with published data supporting the use of dose-dense chemotherapy regimens in ovarian cancer.
  
  
  
  The overall survey response rate was 85% (22/26 sites). Of responders, 27% (6 sites) were fully adherent with all hematologic hold parameters and 64% (14 sites) used hold parameters that differed from the published protocol. Specifically, all of these sites use hold parameters higher than those recommended in the literature. Two centers did not have center-specific hold parameters.
  
  
  
  Carboplatin and dose-dense paclitaxel chemotherapy has been shown to increase progression-free survival and overall survival in patients with stage II-IV ovarian, fallopian tube, or primary peritoneal cancers. However, our study found that two-thirds of queried sites had hold parameters higher than those in the published protocol. Using more stringent hold parameters may lead to compromised clinical outcomes. Further research is necessary to determine the optimal strategy to increase individual site adherence to chemotherapy hematologic hold parameters as specified in published trials.
authors.affiliation: From the Division of Gynecologic Oncology and Gynecologic Health Services Research (G-HSR), Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Marina
authors.initials: M
authors.lastname: Stasenko
authors.affiliation: From the Division of Gynecologic Oncology and Gynecologic Health Services Research (G-HSR), Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
authors.forename: R Kevin
authors.initials: RK
authors.lastname: Reynolds
authors.affiliation: From the Division of Gynecologic Oncology and Gynecologic Health Services Research (G-HSR), Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Johnston
authors.affiliation: From the Division of Gynecologic Oncology and Gynecologic Health Services Research (G-HSR), Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Melissa
authors.initials: M
authors.lastname: Brackman
authors.affiliation: From the Division of Gynecologic Oncology and Gynecologic Health Services Research (G-HSR), Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Karen
authors.initials: K
authors.lastname: McLean
authors.affiliation: From the Division of Gynecologic Oncology and Gynecologic Health Services Research (G-HSR), Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan. From the Division of Gynecologic Oncology and Gynecologic Health Services Research (G-HSR), Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Shitanshu
authors.initials: S
authors.lastname: Uppal
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel