Randomized study of sequential cisplatin-topotecan/carboplatin-paclitaxel versus carboplatin-paclitaxel: effects on quality of life.

TitleRandomized study of sequential cisplatin-topotecan/carboplatin-paclitaxel versus carboplatin-paclitaxel: effects on quality of life.
Publication TypeJournal Article
Year of Publication2016
AuthorsBrotto, L, Brundage, M, Hoskins, P, Vergote, IB, Cervantes, A, Casado, HA, Poveda, AM, Eisenhauer, E, Tu, D
Corporate AuthorsGynecologic Cancer Intergroup Study of the NCIC Clinical Trials Group (NCIC CTG), the European Organization for Research and Treatment of Cancer—Gynecologic Cancer Group (EORTC-GCG) and the Grupo de Investigación de Cáncer de Ovario (GEICO)
JournalSupport Care Cancer
Volume24
Start Page1241
Issue3
Pagination1249
Date Published03/2016
ISSN1433-7339
Keywordscarboplatin-paclitaxel, cisplatin-topotecan, qol, Quality of Life, Randomized
Abstract

BACKGROUND: A recent phase III trial compared the efficacy of cisplatin-topotecan (a topoisomerase I inhibitor) followed by carboplatin-paclitaxel (Arm 1) versus paclitaxel-carboplatin (Arm 2) in women with newly diagnosed stage IIB or greater ovarian cancer. There was a significantly lower response rate in the experimental arm compared to standard treatment, and less likelihood of normalized CA125 within the first 3 months. At 43 months follow-up, there were no significant group differences in progression-free survival. There were also significantly more side effects in the experimental arm.METHODS: The current study examined quality of life (QoL) endpoints using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and the ovarian cancer module, QLQ-OV28, administered prior to randomization, at day 1 of treatment cycles 3, 5, and 7, at completion of the last cycle, and at 3 and 6 months following completion of chemotherapy.RESULTS: Global QoL, physical symptoms, fatigue, and role, emotional, cognitive and social function (all from the EORTC QLQ-C30) significantly improved in both treatment arms, with no significant between-arm differences. Between-group differences in pain, insomnia, and peripheral neuropathy reported while on treatment did not differ at follow-up. Nausea and vomiting improved more with standard treatment both during and after treatment. Body image significantly differed between the groups only at cycle 5 (more deterioration in Arm 2) but group differences disappeared at follow-up. A stratified analysis of global QoL by debulking surgery status found no greater effect indicating that overall improvements in QoL were unrelated to surgical recovery.CONCLUSIONS: There was no significant QoL advantage of cisplatin-topotecan. This finding, combined with no progression-free survival conferred by this combination, reaffirms carboplatin-paclitaxel as the standard of care for women with newly diagnosed ovarian cancer.

DOI10.1007/s00520-015-2873-8
Alternate JournalSupport Care Cancer
PubMed ID26304156