Patterns of chemotherapy treatment for women with invasive epithelial ovarian cancer - A population-based study

Objective: Ovarian cancer five-year survival is poor at < 40%. In the absence of effective screening or new treatments, ensuring all women receive optimal treatment is one avenue to improve survival. There is little population-based information regarding the primary chemotherapy treatment that women with epithelial ovarian cancer receive. This information is essential to identify potential gaps in care. Methods: Cancer registries identified all women diagnosed with invasive epithelial ovarian cancer in Australia in 2005 (n = 1192). Histopathology, chemotherapy and comorbidity information was abstracted from medical records. Multivariable logistic regression was used to identify factors associated with chemotherapy commencement, regimen, and completion. Results: Women > 70 years (p < 0.0001), those with high-grade, stage IA/IB cancers (vs. stages IC-IV, p = 0.003) and those with mucinous cancers (p = 0.0002) were less likely to start chemotherapy. Most treated women received platinum-based drugs (97%), but only 68% received combination carboplatin-paclitaxel and only half completed six cycles without treatment modification/delay. Approximately 19% received single-agent carboplatin: mostly those aged > 70 (p < 0.0001) and/or with co-morbidities (p < 0.0001). Age was the strongest predictor of completing six cycles of combination therapy. Conclusions: For specific patient groups, particularly older women, there is notable variation from standard treatment. Understanding how treatment variations affect survival and determining optimal regimens for these groups are research priorities.