Risk factors for hematological toxicity of adjuvant chemotherapy and prognosis analysis in elderly patients with epithelial ovarian cancer / 中华老年医学杂志

ABSTRACT

Objective:To investigate risk factors for severe hematological toxicity of adjuvant chemotherapy and prognostic factors in elderly patients with ovarian cancer.Methods:We retrospectively analyzed 117 ovarian cancer patients aged 60 years and older who underwent surgery followed by adjuvant chemotherapy between January 2006 to December 2016 at Beijing Hospital.Risk factors for grade Ⅲ-Ⅳ hematological toxicity were assessed by using multivariate logistic regression analysis.Prognostic factors influencing progression-free survival(PFS)were evaluated by univariate and multivariate Cox regression analysis.Results:The mean age of patients was(69.3±7.9)years.After surgery, 67.3% patients(70/104)had a satisfactory tumor reduction, and 83.5%(86/103)received a standard treatment.Multivariable logistic regression analysis showed that risk factors for severe hematological toxicity included albumin level<40 g/L( OR=3.434, 95% CI 1.074~10.968)and age>75( OR=3.676, 95% CI 1.032~13.093). Progression-free survival for patients was 20.4 months(95% CI 19.4~26.0). Univariate Cox regression analysis showed that FIGO(the International Federation of Gynecology and Obstetrics)staging, pelvic lymphadenectomy, tumor burden, transfusion therapy and residual tumor size were risk factors influencing 3-year PFS.Multivariate Cox regression analysis showed that low tumor burden was the only independent risk factor for 3-year PFS( HR=2.067, 95% CI 1.174~4.424, P=0.023). Conclusions:Age ≥75 and albumin levels have effects on the incidences of complications during adjuvant chemotherapy, which in turn affect whether patients can complete standard adjuvant therapy and the clinical outcome of patients with ovarian cancer after surgery.To maximize the efficacy of treatment and reduce the side effects of adjuvant therapy, individualized treatment plans should be formulated for elderly patients with poor prognostic factors.