Comparison of Tolerance of Combination Carboplatin and Paclitaxel Chemotherapy by Age in Women with Ovarian Cancer

Objective. The objective of this study was to compare tolerance of treatment of ovarian cancer patients ≥ 70 years to those ≤55. Materials and methods. A retrospective review of all data relevant to comparison of clinical course in 31 women ≥70 years (Study Group) and 44 women ≤55 (Control Group), who received primary therapy for ovarian cancer between 1996 and 2001 was performed. The tolerance of the entire treatment plan was then compared using SAS 8.1 (Gary, IN), χ 2 test with Yates correction or Fischer's exact test, and the Student t test as appropriate. Results. The mean age for the study group was 73, and for the control group 49. Statistically significant differences were as follows: the study group had a lower hemoglobin and serum albumin, higher performance status postoperatively, and received lower carboplatin dose and dose intensity. The groups were similar in stage at presentation, medical comorbidities, estimated blood loss, optimal cytoreduction rates, dose intensity of paclitaxel, completed number of chemotherapy cycles, time intervals from surgery to completion of therapy, and posttreatment performance status and nutritional status. The rate of grade 3 and 4 toxicities was low in both groups, and did not hinder delivery of therapeutic dose of chemotherapy. Conclusion. Women in the study group tolerated aggressive cytoreductive surgery and therapeutic doses of chemotherapy, despite poorer nutritional status and general health at time of diagnosis. Although older women are more likely to have chemotherapy dose reduction, the treatment remained within the recommended standard dosage.