In:
Oncology, S. Karger AG, Vol. 98, No. 3 ( 2020), p. 146-153
Abstract:
〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 Platinum-based chemotherapy is the standard treatment for metastatic urothelial carcinoma (mUC). However, considering elderly patients often experience comorbidities and frailty, the utility of cisplatin-based chemotherapy for elderly patients is still debatable. We conducted this study to compare the safety and efficacy of carboplatin and cisplatin in elderly patients with mUC. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This retrospective study enrolled elderly patients with mUC (defined as aged ≥70 years) who underwent first-line platinum-based chemotherapy between September 2001 and October 2018. The primary endpoints were chemotherapy-related adverse events (AEs), including treatment-related hospitalization or death. The secondary outcomes were overall survival (OS) and progression-free survival calculated by Kaplan-Meier analysis. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In total, 108 elderly patients with mUC were enrolled and allocated into the cisplatin or carboplatin group. Patients treated with carboplatin-based chemotherapy had a significantly higher incidence of all grade ≥3 AEs (78.8 vs. 50.0%, 〈 i 〉 p 〈 /i 〉 = 0.008) than those on cisplatin. AE-related hospitalization (47.5 vs. 19.1%, 〈 i 〉 p 〈 /i 〉 = 0.002) and treatment-related death (17.5 vs. 4.4%, 〈 i 〉 p 〈 /i 〉 = 0.02) were significantly increased in the carboplatin group. In the univariate analysis, the median OS in the cisplatin group was significantly increased compared with the carboplatin group (13.6 vs. 7.2 months, 〈 i 〉 p 〈 /i 〉 = 0.045). The Cox multivariate regression model indicated that leukocytosis (HR 3.17, 95% CI 1.84–5.46, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) and anemia (HR 2.02, 95% CI 1.11–3.65, 〈 i 〉 p 〈 /i 〉 = 0.02) were independent prognostic factors. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Elderly patients with mUC treated with cisplatin-based chemotherapy had better survival and safety profiles than those treated with carboplatin. Age itself was not a crucial factor in determining cisplatin eligibility.
Type of Medium:
Online Resource
ISSN:
0030-2414
,
1423-0232
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
1483096-6
detail.hit.zdb_id:
250101-6
