Impact of Interruptions in Chemotherapy on Survival for Patients With Metastatic or Recurrent Cervical Cancer

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVES: Chemotherapy interruptions are a frequent event during treatment of solid tumors and have been associated with adverse survival outcomes. Our objective was to determine the impact of intercycle delay during first-line systemic chemotherapy on survival in patients with metastatic (stage IVB) or recurrent cervical cancer. METHODS: A retrospective cohort study identified patients with metastatic or recurrent cervical cancer treated at our institutions. Demographics, clinicopathologic information, first-line chemotherapy regimens with associated intercycle delays, and outcome measures were abstracted from medical records. Delays were categorized as modifiable (social determinants of health, logistics, treatment break) or nonmodifiable (cytopenias, organ dysfunction, chemotherapy reaction, infection, ECOG status). Data were analyzed using descriptive statistics, Kaplan-Meier survival estimate, and log-rank tests to calculate significance ( P <0.05). RESULTS: Two hundred ten patients were evaluable for this study. 178 (85%) had at least one intercycle delay. One thousand eight hundred seventy-three chemotherapy cycles were completed with 701 (37%) delays. There was an equal proportion of modifiable (352/701) and nonmodifiable (349/701) delays. Patients with one or more intercycle delay had a longer median PFS (13 mo, IQR: 7 to 24) compared with those without delays (8 mo, IQR: 4 to 17), P =0.042. PFS stratified by subgroups revealed patients with modifiable delays as having improved PFS ( P =0.036) and nonmodifiable subgroup trending towards improved PFS ( P =0.058) compared with patients with no delays. There was no PFS difference between the modifiable and nonmodifiable subgroups and no overall survival differences. CONCLUSIONS: Intercycle delays during first-line systemic chemotherapy for metastatic or recurrent cervical cancer do not have an adverse effect on survival.