Systematic Review of Paclitaxel Intensive Therapy for Ovarian Epithelial Cancer_Chinese Journal of Evidence-Based Medicine

Authors：

1. Department of Obstetrics and Gynecology, West China Second University Hospital, 610041; 2. Evidence-Based Medicine and Clinical Epidemiology Centre, West China Hospital, 610041;

Corresponding author：

Keywords：

Paclitaxe; Intensive therapy; Conventional therapy; Ovarian cancer; Systematic review

DOI：

10.7507/1672-2531.20090241

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To evaluate the efficacy and the adverse reactions of intensive therapy compared with conventional therapy.
Methods 　We searched the Cochrane Central Register of Controlled Trials (Issue 3, 2008), MEDLINE (January 1980 to June 2008), EMbase (1984 to June 2008), CBM-disc (January 1980 to June 2008) and CNKI (1994 to June 2008) to get all the randomized control trials (RCTs) about paclitaxel intensive versus conventional therapy for ovarian cancer. We used RevMan 5 to perform meta-analysis.
Results 　Six RCTs involving 572 patients were included. Metaanalysis showed the efficacy of intensive therapy and conventional therapy was similar. There were no significant differences in response rate (RR 1.06, 95%CI 0.94 to 1.20), median survival time, survival rate, median progression free survival and median time to progression between the two groups. When taking safety into consideration, intensive therapy significantly reduced the occurrence of grade Ⅲ or higher neutropenia (RR 0.49, 95%CI 0.35 to 0.69, P lt;0.000 1) and Grade Ⅲ or higher neuropathy (RR 0.43, 95%CI 0.24 to 0.78, P=0.006). But there were no significant differences between intensive therapy and conventional therapy in flush, grade Ⅲ or higher vomiting, anemia, leucopenia, grade Ⅲ or higher thrombocytopenia and alopecia.
Conclusion 　Paclitaxel intensive therapy has similar efficacy and adverse reactions compared with conventional therapy in ovarian cancer. Above all, intensive therapy can reduce the incidence of grade Ⅲ or higher neutropenia and neuropathy. It is a good substitution for the conventional therapy.

Citation： CHENG Meng,XIE Cong,WANG Danqing,YIN Rutie,KANG Deying. Systematic Review of Paclitaxel Intensive Therapy for Ovarian Epithelial Cancer. Chinese Journal of Evidence-Based Medicine, 2009, 09(12): 1328-1335. doi: 10.7507/1672-2531.20090241 Copy

1.	Wang TH, Wang HS, Soong YK. Paclitaxel-induced cell death: where the cell cycle and apoptosis come together. Cancer, 2000, 88(11): 2619-2628.
2.	Kuh HJ, Jang SH, Wientjes MG, et al. Computational model of intracellular pharmacokinetics of paclitaxel. J Pharmacol Exp Ther, 2000, 293(3): 761-770.
3.	陆红霞. 紫杉醇剂型、临床用药方式及联合用药的研究进展. 国外医学药学分册, 2005, 2(32): 73-77。.
4.	Mori T, Kinoshita Y, Watanabe A, et al. Retention of paclitaxel in cancer cells for 1 week in vivo and in vitro. Cancer Chemother Pharmacol, 2006, 58(5): 665-672.
5.	Choy H, Akerley W, Safran H, et al. Phase I trial of outpatient weekly paclitaxel and concurrent radiation therapy for advanced non-smallcell lung cancer. J Clin Oncol, 1994, 12(12): 2682-2686.
6.	Sehouli J, Stengel D, Mustea A, et al. Weekly paclitaxel and carboplatin (PC-W) for patients with primary advanced ovarian cancer: results of a multicenter phase-II study of the NOGGO. Cancer Chemother Pharmacol, 2008, 61(2): 243-250.
7.	Higgins JLT, Green S. The Cochrane collaboration. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6. The Cochrane Library, 2006.
8.	Rosenberg P, Andersson H, Boman K, et al. Randomized trial of single agent paclitaxel given weekly versus every three weeks and with peroral versus intravenous steroid premedication to patients with ovarian cancer previously treated with platinum. Acta Oncol, 2002, 41(5): 418- 424.
9.	Wu CH, Yang CH, Lee JN, et al. Weekly and monthly regimens of paclitaxel and carboplatin in the management of advanced ovarian cancer. A preliminary report on side effects. Int J Gynecol Cancer, 2001, 11(4): 295-299.
10.	de Jongh FE, de Wit R, Verweij J, et al. Dose-dense cisplatin/paclitaxel. a well-tolerated and highly effective chemotherapeutic regimen in patients with advanced ovarian cancer. Eur J Cancer, 2002, 38(15): 2005-2013.
11.	段微, 路虹, 范逢晓. 国产紫杉醇治疗上皮性卵巢癌周疗方案与月疗方案的比较. 中国肿瘤临床与康复, 2006, 13(1): 73-74.
12.	朱丽荣, 廖秦平, 温宏武, 等. 紫杉醇治疗卵巢癌周疗与月疗的临床对比研究. 中国医刊, 2004, 39(4): 32-37.
13.	沈铿, 李孟达, 丰有吉, 等. 代表中国妇科肿瘤学组. 泰素周疗和三周疗法作为卵巢癌一线化疗的多中心对照研究. 中华医学杂志, 2005, 8(30): 2099-2103.
14.	Gianni L, Keens CM, Gianni A, et al. Non-linear pharmacokinetics and metabolism of paclitaxel and its pharmacokinetic/ pharmacodynamic relationships in humans. J Clin Oncol, 1995, 13: 180-190.
15.	Kurihara M, Sakamoto H, Ohta Y, et al. Patient compliance and the quality of life are well maintained in weekly paclitaxel and carboplatin therapy for advanced gynecologic cancers in Japanese women. Gan To Kagaku Ryoho, 2001, 28: 55-61.

1. Wang TH, Wang HS, Soong YK. Paclitaxel-induced cell death: where the cell cycle and apoptosis come together. Cancer, 2000, 88(11): 2619-2628.
2. Kuh HJ, Jang SH, Wientjes MG, et al. Computational model of intracellular pharmacokinetics of paclitaxel. J Pharmacol Exp Ther, 2000, 293(3): 761-770.
3. 陆红霞. 紫杉醇剂型、临床用药方式及联合用药的研究进展. 国外医学药学分册, 2005, 2(32): 73-77。.
4. Mori T, Kinoshita Y, Watanabe A, et al. Retention of paclitaxel in cancer cells for 1 week in vivo and in vitro. Cancer Chemother Pharmacol, 2006, 58(5): 665-672.
5. Choy H, Akerley W, Safran H, et al. Phase I trial of outpatient weekly paclitaxel and concurrent radiation therapy for advanced non-smallcell lung cancer. J Clin Oncol, 1994, 12(12): 2682-2686.
6. Sehouli J, Stengel D, Mustea A, et al. Weekly paclitaxel and carboplatin (PC-W) for patients with primary advanced ovarian cancer: results of a multicenter phase-II study of the NOGGO. Cancer Chemother Pharmacol, 2008, 61(2): 243-250.
7. Higgins JLT, Green S. The Cochrane collaboration. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6. The Cochrane Library, 2006.
8. Rosenberg P, Andersson H, Boman K, et al. Randomized trial of single agent paclitaxel given weekly versus every three weeks and with peroral versus intravenous steroid premedication to patients with ovarian cancer previously treated with platinum. Acta Oncol, 2002, 41(5): 418- 424.
9. Wu CH, Yang CH, Lee JN, et al. Weekly and monthly regimens of paclitaxel and carboplatin in the management of advanced ovarian cancer. A preliminary report on side effects. Int J Gynecol Cancer, 2001, 11(4): 295-299.
10. de Jongh FE, de Wit R, Verweij J, et al. Dose-dense cisplatin/paclitaxel. a well-tolerated and highly effective chemotherapeutic regimen in patients with advanced ovarian cancer. Eur J Cancer, 2002, 38(15): 2005-2013.
11. 段微, 路虹, 范逢晓. 国产紫杉醇治疗上皮性卵巢癌周疗方案与月疗方案的比较. 中国肿瘤临床与康复, 2006, 13(1): 73-74.
12. 朱丽荣, 廖秦平, 温宏武, 等. 紫杉醇治疗卵巢癌周疗与月疗的临床对比研究. 中国医刊, 2004, 39(4): 32-37.
13. 沈铿, 李孟达, 丰有吉, 等. 代表中国妇科肿瘤学组. 泰素周疗和三周疗法作为卵巢癌一线化疗的多中心对照研究. 中华医学杂志, 2005, 8(30): 2099-2103.
14. Gianni L, Keens CM, Gianni A, et al. Non-linear pharmacokinetics and metabolism of paclitaxel and its pharmacokinetic/ pharmacodynamic relationships in humans. J Clin Oncol, 1995, 13: 180-190.
15. Kurihara M, Sakamoto H, Ohta Y, et al. Patient compliance and the quality of life are well maintained in weekly paclitaxel and carboplatin therapy for advanced gynecologic cancers in Japanese women. Gan To Kagaku Ryoho, 2001, 28: 55-61.

Chinese Journal of Evidence-Based Medicine

Systematic Review of Paclitaxel Intensive Therapy for Ovarian Epithelial Cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content