We compared oncologic and clinical outcomes in patients with advanced ovarian cancer who received dose dense weekly paclitaxel with 3-weekly Carboplatin compared to standard 3-weekly chemotherapy.
Comparison of all consecutive patients with advanced (International Federation of Gynecology and Obstetrics stages III-IV) ovarian cancer who received dose dense protocol between 2010-2016 to an immediate historical cohort of consecutive patients who received standard chemotherapy. Patients who received less than 3 cycles of treatment were excluded.
246 patients were included in the study, of whom 128 received dose dense protocol and 118 were treated with the standard Q3 weeks protocol. Patients in the dose dense group had significantly better progression free survival than the standard protocol (median progression free survival 22 vs. 15 months; log rank = 0.026). The overall survival of patients in the dose dense group was also better than that of the patients in the standard protocol group, however, this difference was not statistically significant (median overall survival 66 vs. 54 months; log rank = 0.185). Dose dense protocol remained significantly associated with favorable survival outcome in multivariable analysis adjusted for stage, histological type, cytoreductive results, and neoadjuvant chemotherapy. The use of dose dense protocol was associated with higher rates of gastrointestinal, dermatologic, neurologic, and hematologic side effects.
Despite the limitations associated with the comparison to a historical cohort, dose dense chemotherapy protocol resulted in a significantly improved progression free survival and overall survival tended to be better, but this difference did not reach statistical significance compared to the standard chemotherapy protocol, and may be considered as a treatment alternative, albeit with some increased side effects.
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