European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany; Dresden International University, Division of Health Care Sciences, Center for Clinical Research and Management Education, Freiberger Str. 37, 01067 Dresden, Germany.
European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Gynecol Oncol. 2016 Mar;140(3):554-8. doi: 10.1016/j.ygyno.2016.01.012. Epub 2016 Jan 11.
Ovarian cancer is mostly diagnosed in the elderly woman who is likely to have comorbid disease and to take several comedications on a regular basis. Aim of this study was to evaluate the influence of polypharmacy on grade III/IV toxicity, prior discontinuation of chemotherapy and survival.
In this individual participant data meta-analysis the original data of three phase II/III studies of the North-Eastern German Society of Gynecological Oncology (NOGGO) were analyzed using multivariate logistic and Cox regression.
Overall, 1213 patients with recurrent ovarian cancer were included in these analyses. An increasing amount of medication was associated with overall grade III/IV toxicity (p<0.001; OR 1.120), and hematological (p<0.001; OR 1.056) and non-hematological (p<0.001; OR 1.134) toxicities. Prior discontinuation of chemotherapy was not influenced by an increasing amount of medication (p=0.196). There was no association of polypharmacy with overall survival (p=0.068).
As polypharmacy does not influence survival ovarian cancer patients taking several comedications may be included in clinical trials and should not be deprived of adequate cancer treatment. However, a thorough monitoring is mandatory due to the increased risk of toxicities.
卵巢癌大多发生在老年女性中，这些患者往往患有合并症，并经常定期服用多种药物。本研究旨在评估多种药物治疗对 III/IV 级毒性、化疗前停药和生存的影响。
在这项个体参与者数据的荟萃分析中，使用多变量逻辑回归和 Cox 回归分析了东北德国妇科肿瘤学会（NOGGO）的三项 II/III 期研究的原始数据。
共有 1213 例复发性卵巢癌患者纳入了这些分析。药物使用种类的增加与总体 III/IV 级毒性（p<0.001；OR 1.120）以及血液学毒性（p<0.001；OR 1.056）和非血液学毒性（p<0.001；OR 1.134）相关。药物使用种类的增加与化疗前停药无关（p=0.196）。多种药物治疗与总生存期无关联（p=0.068）。
由于多种药物治疗并不影响生存，因此可以考虑让服用多种药物的卵巢癌患者参加临床试验，而不应剥夺他们接受充分癌症治疗的机会。但是，由于毒性风险增加，必须进行彻底的监测。
