Meta Analysis Of Dose-dense Paclitaxel Therapy For Ovarian Epithelial Cancer

Epithelial ovarian cancer (EOC) is one of the most common female reproductive malignancies, and it holds highest mortality of the female reproductive malignancies. Because of the location of the ovarians is deep, it has difficult to diagnose ovarian cancer at an earlier cancers, 70% of patients are diagnosed at advanced stages. Patients are primarily managed with surgery and chemotherapy. At present, paclitaxel plus carboplatin become the first-line chemotherapeutic regimen of EOC. The period of conventional paclitaxel proposal is 3 weeks. Because of the period specificity of paclitaxel, we can increase the time of contact between drug and tumor cells, and then eliminate tumor more efficiently, dose-dense paclitaxel is popularized in ovarian cancer chemotherapy. It is controversial which is more efficient and safe between the conventional and dose-dense proposal of paclitaxel at present.Objective: To evaluate the efficacy and the adverse reactions of dose-dense therapy compared with conventional therapy.Methods: From 1980 to 2011, We searched PUBMED, EMBASE, MEDLINE, CNKI, CMCC and VIP using Cochrane Collaboration systematic review methods to obtain randomized controlled trials about paclitaxel dose-dense versus conventional therapy for ovarian cancer. Response rate, overall survival at 2 years, overall survival at 3 years and toxic effects are evaluation index. We used RevMan 4.2 to perform meta-analysis.Results: 9 RCTs involving 1154 patients were included. Meta-analysis showed the efficacy of dose-dense therapy and conventional therapy was similar. There were no significant differences in response rate, overall survival at 2 years and overall survival at 3 years between the two groups. Taking safety into consideration, dose-dense therapy significantly increase the occurrence of gradeâ…¢/â…£anemia, and reduced the occurrence of gradeâ…¢or higher neuropathy. But there were no significant differences between dose-dense therapy and conventional therapy in other adverse events.Conclusion: 1 There were no significant differences in efficiency between the two groups. 2 Dose-dense therapy significantly increase the occurrence of gradeâ…¢or higher anemia, and reduced the occurrence of gradeâ…¢or higher neuropathy. 3 It is a good optional substitution for the conventional therapy.