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Abstract：
OBJECTIVE: To explore the difference in chemotherapy completion and reasons for discontinuation between older (≥70 years) and younger (<70 years) patients.
METHODS: Retrospective cohort study.
METHODS: Single tertiary centre in Thailand.
METHODS: The patients who received chemotherapy from 1 January 2009 to 30 June 2021 were included and followed up until 30 June 2022. Of the 757 patients with epithelial ovarian, fallopian tube and primary peritoneal cancer (EOC), 108 were in the older group and 649 were in the younger group.
METHODS: The difference in chemotherapy completion, the association between younger and older patients and early discontinuation of chemotherapy.
RESULTS: The proportion of chemotherapy completion was significantly lower in older versus younger patients (84.3% versus 92.6%, p=0.007). Excluding discontinuation due to disease progression, the chemotherapy completion was comparable (93.5 versus 95.7%, p=0.456). Dose reduction and grade 3-4 hematotoxicity occurred more often in the older group. The univariable logistic regression model showed that older age (≥70 years) was significantly associated with early chemotherapy discontinuation (OR 2.39; 95% CI 1.29-4.24). However, after adjusting for potential confounders, age was not significantly associated with early discontinuation (OR 1.20; 95% CI 0.54-2.66). Multiple comorbidities and types of surgery were identified as independent risk factors for chemotherapy discontinuation.
CONCLUSIONS: The completion of chemotherapy was observed in a majority of older adults with EOC. Age is not the only determinant of chemotherapy completion. Comorbidity and disease status are crucial for determining chemotherapy discontinuation.
METHODS: Retrospective cohort study.
METHODS: Single tertiary centre in Thailand.
METHODS: The patients who received chemotherapy from 1 January 2009 to 30 June 2021 were included and followed up until 30 June 2022. Of the 757 patients with epithelial ovarian, fallopian tube and primary peritoneal cancer (EOC), 108 were in the older group and 649 were in the younger group.
METHODS: The difference in chemotherapy completion, the association between younger and older patients and early discontinuation of chemotherapy.
RESULTS: The proportion of chemotherapy completion was significantly lower in older versus younger patients (84.3% versus 92.6%, p=0.007). Excluding discontinuation due to disease progression, the chemotherapy completion was comparable (93.5 versus 95.7%, p=0.456). Dose reduction and grade 3-4 hematotoxicity occurred more often in the older group. The univariable logistic regression model showed that older age (≥70 years) was significantly associated with early chemotherapy discontinuation (OR 2.39; 95% CI 1.29-4.24). However, after adjusting for potential confounders, age was not significantly associated with early discontinuation (OR 1.20; 95% CI 0.54-2.66). Multiple comorbidities and types of surgery were identified as independent risk factors for chemotherapy discontinuation.
CONCLUSIONS: The completion of chemotherapy was observed in a majority of older adults with EOC. Age is not the only determinant of chemotherapy completion. Comorbidity and disease status are crucial for determining chemotherapy discontinuation.
摘要：
目的：探讨老年（≥70岁）和年轻（<70岁）患者化疗完成和停药原因的差异。
方法：回顾性队列研究。
方法：泰国的单一三级中心。
方法：纳入2009年1月1日至2021年6月30日接受化疗的患者，随访至2022年6月30日。在757例上皮性卵巢患者中，输卵管和原发性腹膜癌（EOC），老年组108人，年轻组649人。
方法：化疗完成的差异，年轻和老年患者与早期停止化疗之间的关系。
结果：老年患者完成化疗的比例明显低于年轻患者（84.3%vs92.6%，p=0.007)。不包括因疾病进展而停药，化疗完成情况相当（93.5对95.7%，p=0.456)。剂量减少和3-4级血液毒性在老年组中更常见。单变量logistic回归模型显示，年龄（≥70岁）与早期化疗停药显著相关（OR2.39；95%CI1.29-4.24）。然而,在调整了潜在的混杂因素后，年龄与早期停药无显著相关(OR1.20;95%CI0.54-2.66).多种合并症和手术类型被确定为化疗停药的独立危险因素。
结论：在大多数患有EOC的老年人中观察到化疗完成。年龄不是化疗完成的唯一决定因素。合并症和疾病状态对于确定化疗停药至关重要。
方法：回顾性队列研究。
方法：泰国的单一三级中心。
方法：纳入2009年1月1日至2021年6月30日接受化疗的患者，随访至2022年6月30日。在757例上皮性卵巢患者中，输卵管和原发性腹膜癌（EOC），老年组108人，年轻组649人。
方法：化疗完成的差异，年轻和老年患者与早期停止化疗之间的关系。
结果：老年患者完成化疗的比例明显低于年轻患者（84.3%vs92.6%，p=0.007)。不包括因疾病进展而停药，化疗完成情况相当（93.5对95.7%，p=0.456)。剂量减少和3-4级血液毒性在老年组中更常见。单变量logistic回归模型显示，年龄（≥70岁）与早期化疗停药显著相关（OR2.39；95%CI1.29-4.24）。然而,在调整了潜在的混杂因素后，年龄与早期停药无显著相关(OR1.20;95%CI0.54-2.66).多种合并症和手术类型被确定为化疗停药的独立危险因素。
结论：在大多数患有EOC的老年人中观察到化疗完成。年龄不是化疗完成的唯一决定因素。合并症和疾病状态对于确定化疗停药至关重要。
