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The influence of comorbidity and comedication on grade III/IV toxicity and prior discontinuation of chemotherapy in recurrent ovarian cancer patients: An individual participant data meta-analysis of the North-Eastern German Society of Gynecological Oncology (NOGGO).
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2015 Sep; Vol. 138 (3), pp. 735-40. Date of Electronic Publication: 2015 Jul 13. - Publication Year :
- 2015
-
Abstract
- Background: Ovarian cancer is usually a cancer of the older age group. Comorbidities and comedications increase with rising age. Aim of this study was to evaluate association of comorbidity and comedication with grade III/IV toxicities and prior cessation of chemotherapy in ovarian cancer patients.<br />Patients and Methods: As an individual participant data meta-analysis this study analyzes the original data of three phase II/III chemotherapy studies of the North-Eastern German Society of Gynecological Oncology (NOGGO). Risk scores for certain combinations of risk factors were calculated based on stepwise regression analyses.<br />Results: Altogether, 1213 patients were included in the study. Cardiovascular disease was the most frequent comorbidity (47.5%). In multivariate analyses it was associated with hematological, non-hematological, pulmonary and renal grade III/IV toxicities (p=0.002; p<0.001; p=0.005; p<0.001). Renal toxicity was more frequent when using diuretics and ACE-inhibitors (p<0.001; p=0.002). Prior cessation of therapy was e.g. associated with use of diuretics, insulin and digitalis (p=0.001; p=0.04; p=0.03). The risk for renal grade III/IV toxicities was more than 16 times higher when using both a diuretic and an ACE-inhibitor.<br />Conclusions: Regimens of ovarian cancer treatment should not be restricted to direct cancer therapy but rather include additional individualized treatment of comorbidities. Comedications such as diuretics increase grade III/IV toxicities and patients at risk should be closely monitored.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Clinical Trials, Phase II as Topic
Clinical Trials, Phase III as Topic
Comorbidity
Female
Germany epidemiology
Humans
Middle Aged
Multicenter Studies as Topic
Neoplasm Grading
Ovarian Neoplasms epidemiology
Ovarian Neoplasms pathology
Randomized Controlled Trials as Topic
Young Adult
Ovarian Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 138
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 26185017
- Full Text :
- https://doi.org/10.1016/j.ygyno.2015.07.007