Intraperitoneal Cisplatin For Epithelial Ovarian Cancer: A Systematic Review

OBJECTIVE:To access the clinical efficacy and safety of intraperitoneal cisplatin for women with epithelial epithelial ovarian cancer.METHODS:We searched The Cochrane Central Register of Controlled Trials(CENTRAL),PubMed,EMbase,CBMdisc,CNKI,VIP,WANFANG DATABASE and web site of some clinical trials such as Clinical trials,Current controlled trials,PhRMA Clinical Study Results Database. Relevant journals were also hand searched to September 2008. We collected randomized controlled trials (RCT) comparing intraperitoneal cisplatin (IP cisplatin) with intravenous cisplatin (IV cisplatin) for epithelial ovarian cancer. Study selection and quality assessment ,data extraction and analyses were undertaken by two reviewers independently according to the Cochrane Handbook for Systematic Reviews of interventions. Meta-analyses were also performed.RESULTS:Five RCTs involving 1634 eligible patients were included. Three trials (757 patients) compared IV cyclophosphamide (CTX) plus IP cisplatin with IV cisplatin . Two trials (877 patients) compared IV paclitaxel plus IP cisplatin with IV cisplatin .The Meta-analyses showed that IP cisplatin plus the IV paclitaxel could reduce the mortality rate and recurrent rate compared with IV cisplatin for stageâ…¢advance epithelial ovarian cancer. But the incidence of grade 3 to 4 toxicity of haematology, gastrointestinal,fatigue ,infection,abdominal pain,renal , grade 2 to 4 neurology and fever were higher in IP cisplatin than those in IV cisplatin.CONCLUSION:IP cisplatin plus IV paclitaxel could reduce the mortality rate and recurrent rate compared with IV cisplatin for stageâ…¢advance ovarian cancer,but there were more toxicity with IP cisplatin than IV cisplatin.Due to the difference of IP chemotherapy regimen,more well-designed multi-center randmozied controlled trials should be performed to confirm the drug dosage,courses and the regimen of IP chemotherapy.