Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, MB R3E 0L8, Canada.
Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada.
Curr Oncol. 2024 Mar 5;31(3):1348-1358. doi: 10.3390/curroncol31030102.
In Canada, individuals with gynecologic reproductive organs (ovaries, fallopian tubes, uterus) over the age of 70 comprise a large proportion of epithelial ovarian cancer patients. These patients often have co-morbidities, polypharmacy, or decreased functional status that may impact treatment initiation and tolerance. Despite this, there is limited evidence to guide treatment for older patients diagnosed with ovarian epithelial carcinoma.
This is a retrospective study with data from Manitoba, Canada. The data were obtained from the Manitoba Ovarian Cancer Database, the Manitoba Cancer Registry, and electronic health records. All individuals with epithelial ovarian, fallopian tube, or peritoneal cancer diagnosed between 2009 and 2018 were identified. Patients aged > 70 at the time of diagnosis were included in the study cohort.
Four hundred and forty individuals were included. The majority had advanced stage disease (56%). Moreover, 59% of patients received no chemotherapy. Of the patients who received chemotherapy, 20% received <2 cycles and 21% required a dose reduction due to toxicity. Univariable and multivariable analysis identified advanced stage ( < 0.001), treatment modality ( < 0.001), and advanced age at diagnosis ( < 0.001) with poorer overall survival.
Our study demonstrated a high rate of chemotherapy dose reduction and discontinuation in the elderly epithelial ovarian cancer population. Further research is needed to identify risk factors for treatment discontinuation and intolerance in this population.
在加拿大，70 岁以上有妇科生殖器官（卵巢、输卵管、子宫）的个体构成了上皮性卵巢癌患者的很大一部分。这些患者通常患有合并症、多药治疗或功能状态下降，这可能会影响治疗的开始和耐受。尽管如此，对于诊断为卵巢上皮性癌的老年患者，指导治疗的证据有限。
这是一项来自加拿大马尼托巴省的回顾性研究。数据来自马尼托巴卵巢癌数据库、马尼托巴癌症登记处和电子健康记录。所有在 2009 年至 2018 年间诊断为上皮性卵巢癌、输卵管癌或腹膜癌的个体均被确定。在诊断时年龄>70 岁的患者被纳入研究队列。
共纳入 440 名患者。大多数患者患有晚期疾病（56%）。此外，59%的患者未接受化疗。接受化疗的患者中，20%接受<2 个周期化疗，21%因毒性而需要减少剂量。单变量和多变量分析确定晚期疾病（<0.001）、治疗方式（<0.001）和诊断时的高龄（<0.001）与总体生存较差相关。
我们的研究表明，老年上皮性卵巢癌患者化疗剂量减少和停药的比例较高。需要进一步研究以确定该人群中治疗中断和不耐受的风险因素。
