Department of Gynecological Oncology, Tata Memorial Hospital, Mumbai, India.
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
Cancer Rep (Hoboken). 2020 Apr;3(2):e1217. doi: 10.1002/cnr2.1217. Epub 2019 Oct 3.
One of the primary treatment strategies for advanced epithelial ovarian cancers includes neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) and adjuvant chemotherapy. Compliance to treatment is important to possibly improve outcomes.
To audit treatment compliance and its effect on overall survival (OS) and disease free survival (DFS) in women undergoing IDS.
Women diagnosed with advanced epithelial ovarian cancer undergoing IDS were included. Details of compliance to chemotherapy and surgery as per standard guidelines were assessed, and correlation with survival was studied. Reasons for protocol deviation at various levels were documented and analysed. A total of 182 patients were included. The total number of deviations was 134 with deviation at any level being 89 (48.9%) and at all levels 5%. Both patient- and treatment-related factors contributed towards deviation. Deviation or noncompliance towards treatment resulted in a significantly reduced 5-year OS (34.4% vs 58.2%; P = .001) compared with compliant patients, which retained its significance on multivariate analysis (P = .024) as well.
Deviation from treatment guidelines resulted in a significantly lower 5-year OS compared with those who remained treatment compliant. Both patient- and treatment-related factors contributed towards noncompliance and hence towards lower survival.
晚期上皮性卵巢癌的主要治疗策略之一包括新辅助化疗（NACT）后行间隔减瘤手术（IDS）和辅助化疗。治疗依从性对于改善预后非常重要。
对接受 IDS 的患者进行治疗依从性评估，并分析其对总生存期（OS）和无病生存期（DFS）的影响。
纳入接受 IDS 的晚期上皮性卵巢癌患者。根据标准指南评估化疗和手术的依从性，并研究其与生存的相关性。记录并分析了各个层面的方案偏离原因。共纳入 182 例患者。总偏离次数为 134 次，任何层面的偏离率为 89 次（48.9%），所有层面的偏离率为 5%。患者和治疗相关因素均导致了偏离。与依从治疗的患者相比，治疗偏离或不依从导致 5 年 OS 显著降低（34.4%比 58.2%；P =.001），多因素分析也具有显著意义（P =.024）。
与依从治疗的患者相比，治疗方案偏离导致 5 年 OS 显著降低。患者和治疗相关因素均导致了不依从，从而降低了生存率。
