Ovarian cancer new treatment 2019.
Knowing that the diagnosis age for a significant proportion of patients is above 65 years old, for a proper therapeutic conduct and in order to avoid treatment interruptions caused by toxicity, it was attempted the adjustment of the initial protocole. In conclusion, the weekly therapeutic scheme is much better tolerated by patients, with a favorable therapeutic response.
Keywords ovarian cancer, fragile age, toxicity, comorbidities Rezumat Vârsta înaintată a pacientelor diagnosticate cu cancer ovarian avansat prezintă un impact major asupra prognosticului, întrucât tratamentul standard de primă linie, carboplatin-paclitaxel administrate la fiecare trei săptămâni, este deseori greu de tolerat din cauza efectelor secundare pronunţate, conducând la pierderea intensităţii dozei sau chiar la întreruperea tratamentului.
Ştiind că vârsta de diagnosticare pentru un procent semnificativ de paciente este mai mare de 65 de ani, pentru o conduită terapeutică adecvată şi pentru a evita amânările tratamentului datorate toxicităţilor, s-a încercat adaptarea protocolului iniţial.
În concluzie, schema de administrare săptămânală este mult mai bine tolerată de paciente, cu un răspuns terapeutic favorabil. Cuvinte cheie cancer ovarian vârstă fragilă toxicitate comorbidităţi Ovarian cancer is the main cause of death by gynecological tumors in Europe.
This combination has a high rate of adverse effects in the general population, such as fatigability, hematological and neurological toxicities, which in elderly patients more than 70 years old can be considered unacceptable, leading to the premature discontinuation of treatment, age itself being considered an unfavorable prognosis factor 3.
In the past 12 years, many studies and clinical trials tried to assess the possibility of administering a tailor-made therapy in elderly ovarian cancer new treatment 2019 diagnosed with advanced stage ovarian cancer.
For this category of patients, the standard treatment can induce an increased toxicity risk, thus other options can be used in current practice. One of the possibilities is the monotherapy with carboplatin.
The result were interpreted as follows. Base on this score, there were identified the patients at risk for developing severe toxicities, the direct consequence being the early discontinuation of the treatment, repetead unplanned hospitalizations, and the aggravation of associated pathologies.
Figure 1. Geriatric vulnerability scale The phase II multicentric MITO-5 study analyzed the tolerability of combined paclitaxel-carboplatin therapy with an weekly administration in patients with fragile age, between January and Mayin a number of 26 patients enrolled.
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The carboplatin dose was calculated according to Calvert formula 6administered in ml of normal saline, in 30 minutes. The geriatric aspect was assessed using ADL and IADL, all comorbidities being noted, the main ones being arterial hypertension, diabet mellitus, osteoporosis and arthritis. Table 1. Patients compliance to treatment The final results were positively reported to the study design, only three ovarian cancer new treatment 2019 of severe toxicity being described out of the 26 treated patients one case of atrial fibrillation in an already diagnosed patient with congestive heart failure, a case of grade-3 hepatic toxicity, and a case of neutropenia and prolonged trombocytopenia.
The estimated median of progression-free survival was ovarian cancer new treatment 2019 In conclusion, the weekly administration had a more reduced toxic profile compared to standard treatment scheme, which makes this treatment adjustment more appropriate for fragile patients diagnosed with advanced ovarian cancer.
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What does the future hold for? Study arm B: carboplatin in monotherapy AUC 5 or 6, in every three weeks. As secondary outcome, there are analyzed: the therapeutic stategies, the overall survival, the progression-free survival, the quality of life, the safety and tolerability, and markers related to age.
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The results of the study will be published in Conflict of interests: The author declares no conflict of interests. Survival for ovarian cancer in Europe: the across-country variation did not shrink in the past decade.
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The Gynecologic Oncology Group experience. A phase II study of weekly carboplatin and paclitaxel as first-line treatment ovarian cancer new treatment 2019 elderly patients with advanced ovarian cancer. Crit Rev Oncol Hematol.
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