Efficacy and safety of paclitaxel and carboplatin for ovarian cancer: A meta-analysis / 解放军医学杂志

ABSTRACT

Objective To systematically evaluate the efficacy and safety of paclitaxel and carboplatin dose-dense weekly compared with the same chemotherapeutics administered every 3 weeks for ovarian cancer. Methods The databases, including PubMed, EMbase, The Cochrane Library (Issue 2, 2016), WHO ICTRP, CNKI, VIP and WanFang Data, were electronically searched from inception to February 2016 to collect the randomized controlled trials (RCTs) about dose-dense weekly paclitaxel and carboplatin vs paclitaxel and carboplatin administered every 3 weeks for ovarian cancer. According to the inclusion and exclusion criteria, two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies, and then meta-analysis was conducted by RevMan5.3 software. Results A total of 9 studies involving 2723 patients were included. The results of meta-analysis showed that, compared with the conventional treatment group, the dose-dense treatment group could significantly prolong the OS (Overall survival) (HR=0.85, 95%CI 0.73-0.98, P=0.03), but no significant difference existed between the two groups in clinical response (OR=1.13, 95%CI 0.91-1.39, P=0.27), survival (OR=1.10, 95%CI 0.99-1.22, P=0.07) and PFS (progression-free survival) (HR=0.89, 95%CI 0.74-1.06, P=0.18). A significantly higher blood system adverse reaction rate was in dose-dense treatment group than in conventional treatment group (OR=1.68, 95%CI 1.20-2.36, P=0.003); however, significantly lower rates of vomiting (OR=0.67, 95%CI 0.54-0.83) and hair loss (OR=0.57, 95%CI 0.44-0.74, P<0.0001) were in dose-dense treatment group. There were no significant difference existed between the two groups in liver function (OR=1.30, 95%CI 0.88-1.90, P=0.19), kidney function (OR=1.07, 95%CI 0.65-1.77, P=0.79), paresthesia (OR=1.13, 95%CI 0.91-1.41, P=0.26) and ECG (OR=0.74, 95%CI 0.35-1.58, P=0.44). Conclusions Current evidences have shown that dose-dense weekly paclitaxel and carboplatin can prolong the OS, lower the rates of vomiting and hair loss, while no significant difference exist between the two groups in clinical response, survival, PFS, liver function, kidney function, paresthesia and ECG. However, a significantly higher blood system adverse reaction rate may occur in dosedense treatment group than in conventional treatment group.