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Systemic review of efficacy and safety of chemotherapy in refractory and relapsed ovarian cancer

LIANG Yuan1,LIU Jia-li2,ZHANG Zhen-yong1,WU Rong1 1.Department of Oncology Ⅱ,Affiliated Shengjing Hospital,China Medical University,Shenyang 110022,P.R.China2.Department of Oncology,Fourth Affiliated Hospital,China Medical University,Shenyang 110032,P.R.China  
OBJECTIVE:To evaluate the chemotherapy efficacy of different chemotherapy regimens in recurrent ovarian cancer.METHODS:The Cochrane Library MEDLINE,EMBASE and CBMDISC databases were searched.Relevant journals,conference papers,thesis and reference list for randomized controlled trials of chemotherapy in recurrent ovarian cancer were also searched by manual retrieval.Two reviewers independently assessed trial quality and extracted data.The Cochrane Collaboration's software RevMan 5.0.23 was used for meta-analysis.RESULTS: Six English articls were included(1 117 patients) and the methodological qualities of one trial was grade A and five were grade B.The Meta-analysis results of platinum-sensitive patients showed that the PFS and OS of carboplatin combination chemotherapy were better than that of carboplatin single agent chemotherapy(HR=1.96,95%CI:1.69-2.29,P0.001;HR=1.79,95%CI:1.15-2.81,P=0.01).The Meta-analysis results of platinum-resistant patients showed that gemcitabine was better than that of pegylated liposomal doxorubicin on PFS(SMD=-1.45,95%CI:-5.93——0.23,P=0.02),while pegylated liposomal doxorubicin was better than that of gemcitabine on OS(SMD=0.59,95%CI:0.34-0.85,P0.001).Topotecan was better than that of treosulfan both on PFS and OS(SMD=1.74,95%CI:1.31-2.18,P0.001;SMD=1.73,95%CI:1.29-2.16,P0.001).CONCLUSION: Based on the available evidence,carboplatin combination chemotherapy should be recommended as the first clinical choice for platinum-sensitive patients,and pegylated liposomal doxorubicin,topotecan and gemcitabine monotherapy or combination chemotherapy for platinum-resistant patients.
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