Quality of Life in Ovarian Cancer Patients Choosing to Receive Salvage Chemotherapy or Palliative Treatment

  • Srisuttayasathien, Manasawee (Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University) ;
  • Khemapech, Nipon (Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University)
  • Published : 2013.12.31


Background: The hypothesis that patients who primarily progress on two consecutive chemotherapy regimens without evidence of clinical benefit may opt for supportive care was investigated. The purpose was to determine the quality of life in recurrent ovarian cancer patients choosing to receive salvage chemotherapy in addition to supportive care or palliative care alone. A secondary objective was to evaluate factors that affect quality of life in ovarian cancer patients. Materials and Methods: A descriptive study was conducted in patients who had histological confirmed epithelial ovarian cancer and failed to respond to at least one regimen of chemotherapy, coming for treatment at the King Chulalongkorn Memorial Hospital in Bangkok, Thailand over a six-month period from August 2012-March 2013. Each patient was asked to complete the FACT-G and a general personal questionnaire. The median quality of life score was analyzed. The Mann Whitney U Test was used to compare the difference between salvage chemotherapy and palliative care groups, and the Kruskal Wallis was used to evaluate other variables. Results: Thirty-eight ovarian cancer patients were identified who failed to respond to chemotherapy. Of the 38, 30 chose salvage chemotherapy and eight palliative care for further treatment. By histology the carcimnomas were predominantly endometrioid subtype and poorly differentiated. The majority of patients in this study had FIGO stage III, and ECOG status 0-1. The median quality of life score was 76.3 (35.8-94.0), with no significant differences between the groups. Factors associated with the quality of life were the ECOG score and number of chemotherapeutic courses. Conclusions: In the setting of refractory or recurrent epithelial ovarian cancer, patients who receive salvage chemotherapy have comparable quality of life scores with patients treated with palliative care alone, providing a contrast with previous studies.


  1. Beesley VL, Green AC, Wyld DK, et al (2013). Quality of life and treatment response among woman with platinumresistant versus platinum-sensitive ovarian cancer treated for progression: A prospective analysis. Gynecol Oncol, [Epub ahead of print]
  2. Berek JS, Jonathan S (2011). Berek and Novak's Gynecology. Philadelphia, USA.
  3. Bodurka-Bevers D, Basen-Engquist K, Carmack CL,et al (2000). Depression, anxiety, and quality of life in patients with epithelial ovarian cancer. Gynecol oncol, 78, 302-8.
  4. Carter JR, Chen MD, Fowler JM, et al (1997). The effect of prolonged cycle of chemotherapy on quality of life in gynecologic cancer patients. J Obstet Gyneacol Res, 23, 197-203.
  5. Cheng KK, Yeung MM (2013). Symptom distress in older adults during cancer therapy: impact on performance status and quality of life. J Geriatr Oncol, 4, 71-7.
  6. Doyle C, Crump M, Pintilie M, et al (2001). Does Palliative Chemotherapy Palliate? Evaluation of expectations, outcomes, and costs in woman receiving chemotherapy for advanced ovarian cancer. J Clin Oncol, 19, 1266-74.
  7. Gordon AN, Tonda M, Sun S, et al (2004). Long-term survival advantage for women treated with pegylated liposomal doxorubicin compared with topotecan in a phase 3 randomized study of recurrent and refractory epithelial ovarian cancer. Gynecol Oncol, 95, 1-8.
  8. Greimel E, Thiel I, PeintingerF, et al (2002). Prospective assessment of quality of life of female cancer patients. Gynecol Oncol, 85, 140-7.
  9. Grzankowski KS, Carney M (2011). Quality of life in ovarian cancer. Cancer Control, 18, 52-8.
  10. Hamilton AB (1999). Psychological aspects of ovarian cancer. Cancer Invest, 17, 335-41.
  11. Lakusta CM, Atkinson MJ, Robinson JW, et al (2001). Quality of life in ovarian cancer patients receiving chemotherapy. Gynecol Oncol, 81, 490-5.
  12. Roland KB, Rodriguez JL, Patterson JR, et al (2013). A literature review of social and psychological needs of ovarian cancer survivors. Psychooncology, 22, 2408-18.
  13. Macquart-Moulin G VP, Palangie T, Bouscary ML, et al (2000). High-dose sequential chemotherapy with recombinant granulocyte colony-stimulating factor and repeated stem-cell support for inflammatory breast cancer patients: does impact on quality of life jeopardize feasibility and acceptability of treatment? J Clin Oncol, 18, 754-64.
  14. Mishra K (2011). Gynaecological malignancies from palliative care perspective. Indian J Palliat Care, 17, 45-51.
  15. National Comprehensive Cancer Network (2013). Epithelial ovarian cancer/fallopian tube cancer/primary peritoneal cancer.
  16. Patnaik A, Doyle C, Oza AM (1998). Palliative therapy in advanced ovarian cancer: balancing patient expectations, quality of life and cost. Anti-Cancer Drug, 9, 869-78.
  17. Peterman AH, Rothrock N, Cella D (2012). Evaluation of health-related quality of life .In: UpToDate, Basow, DS(Ed), UpToDate, Waltham, MA.
  18. Price MA, Bell ML, Friedlander M, et al (2013). Physical symptoms, coping styles and quality of life in recurrent ovarian cancer: A prospective population-based study over the last year of life. Gynecol Oncol, 130, 162-8 .
  19. Sfakianos GP, Havrilesky LJ (2011). A review of costeffectiveness studies in ovarian cancer. Cancer Control, 18, 59-64.
  20. Sun CC, Ramirez PT, Bodurka DC (2007). Quality of life for patients with epithelial ovarian cancer. Nat Clin Pract Oncol, 4, 18-29.
  21. Von Gruenigen VE, Huang HQ, Gil KM, et al (2010). A comparison of quality-of-life domains and clinical factors in ovarian cancer patients: A Gynecologic Oncology Group study. J Pain Symptom Manage, 39, 839-46.
  22. Wang Y, Shen J, Xu Yan (2011) Symptoms and quality of life of advanced cancer patients at home: a cross-sectional study in Shanghai, China. Support Care Cancer, 19, 789-97.
  23. Wilailak S, Lertkhachonsuk A, Lohacharoenvanich N, et al (2011). Quality of life in gynecologic cancer survivors compared to healthy check-up woman. J Gynecol Oncol, 22, 103-9.

Cited by

  1. Social Support and Quality of Life in Turkish Patients with Gynecologic Cancer vol.15, pp.7, 2014,
  2. Coping and Quality of Life in Turkish Women Living with Ovarian Cancer vol.15, pp.9, 2014,
  3. Quality of Life in Gestational Trophoblastic Neoplasia Patients after Treatment in Thailand vol.15, pp.24, 2015,
  4. Cost Effectiveness Analysis of Different Management Strategies between Best Supportive Care and Second-line Chemotherapy for Platinum-resistant or Refractory Ovarian Cancer vol.17, pp.2, 2016,