Historical control study of paclitaxel-carboplatin (TJ) versus conventional platinum-based chemotherapy (CAP) for epithelial ovarian cancer.

BACKGROUND: As the first-line chemotherapy for epithelial ovarian cancer, the paclitaxel-carboplatin (TJ) regimen has replaced the cyclophosphamide, epirubicin, and cisplatin or carboplatin (CAP) regimen in our institutes since 1998. Both regimens were retrospectively compared for effectiveness and safety to verify the adequacy of the TJ regimen. METHODS: Women with epithelial ovarian cancer at FIGO stage Ic-IV were enrolled into the study and were assigned to either the CAP group (57 cases, from 1991 until 1998) or the TJ group (49 cases, from 1998 until 2002). The response rate, progression-free survival (PFS), and overall survival (OS) were compared in both groups. Adverse effects were also evaluated. RESULTS: The TJ group received an average of 6.3 courses of paclitaxel at 170.6 mg/m2 and carboplatin with an AUC of 4.3, while the CAP group received 5.8 courses of cisplatin at 61.4 mg/m2. The response rates were 82.8% in the TJ group and 70.6% in the CAP group at stage III-IV. The median OS was 43.9 months in the TJ group and 44.3 months in the CAP group. There was no statistically significant difference in effectiveness between the two groups. Peripheral neuropathy, myalgia/arthralgia, and allergic reactions were found significantly more often in the TJ group, but every adverse effect occurring in the TJ group was clinically controllable. In contrast, renal dysfunction occurred more frequently in the CAP group. CONCLUSION: This study demonstrated that the TJ regimen is as effective as the CAP regimen in its antitumor effect for epithelial ovarian cancer, and has controllable adverse effects.