PT - JOURNAL ARTICLE AU - Seisuke Kumagai AU - Toru Sugiyama AU - Tadahiro Shoji AU - Hirofumi Michimae AU - Noriyuki Katsumata AU - Daisuke Aoki AU - Fumitoshi Terauchi AU - Toshiko Jobo AU - Kazunori Ochiai AU - Makoto Yasuda TI - Does Severe Anemia Caused by Dose-Dense Paclitaxel-Carboplatin Combination Therapy Have an Effect on the Survival of Patients With Epithelial Ovarian Cancer? Retrospective Analysis of the Japanese Gynecologic Oncology Group 3016 Trial AID - 10.1097/IGC.0b013e318229266a DP - 2011 Nov 01 TA - International Journal of Gynecologic Cancer PG - 1585--1591 VI - 21 IP - 9 4099 - http://ijgc.bmj.com/content/21/9/1585.short 4100 - http://ijgc.bmj.com/content/21/9/1585.full SO - Int J Gynecol Cancer2011 Nov 01; 21 AB - Introduction To evaluate the incidence of anemia in patients with epithelial ovarian cancer receiving paclitaxel-carboplatin combination therapy (TC) using data from the Japanese Gynecologic Oncology Group (JGOG) 3016 trial, and to examine the effect of severe anemia on survival during dose-dense TC.Methods Retrospective analysis was conducted in patients enrolled in the JGOG 3016 trial who underwent at least one cycle of the protocol therapy (n = 622). Hemoglobin values at enrollment and during each cycle of TC were collected. One-to-one matching was performed between patients with and patients without grade 3/4 anemia during TC (anemia and nonanemia groups) to adjust the baseline characteristics of the patients. The cumulative survival curve and median progression-free survival were estimated using the Kaplan-Meier method.Results Grades 2 to 4 anemia was observed in 19.8% of patients before first-line TC. The incidence of grade 3/4 anemia rapidly increased to 56.1% after the fourth cycle of dose-dense TC. After matching, the median progression-free survival in the anemia (hemoglobin <8.0 g/dL) and nonanemia (hemoglobin >8.0 g/dL) groups was 777 and 1100 days, respectively (P = 0.3493) for patients receiving dose-dense TC. The median progression-free survival in patients receiving conventional TC was similar between the 2 groups.Conclusions The difference in progression-free survival between patients with epithelial ovarian cancer with and those without severe anemia during TC was not statistically significant, but for patients receiving dose-dense TC, severe anemia seems to have prognostic relevance. Prospective trials are needed to investigate whether the optimal management of chemotherapy-induced anemia, including appropriate use of erythropoiesis-stimulating agents, would further improve the survival of patients with ovarian cancer receiving dose-dense TC.