METAANALYSIS OF CHEMOTHERAPY REGIMENS FOR OVARIAN-CARCINOMA - A REASSESSMENT OF CISPLATIN, CYCLOPHOSPHAMIDE AND DOXORUBICIN VERSUS CISPLATIN AND CYCLOPHOSPHAMIDE

Objective: To compare three year survival, median survival and improve d longevity with the addition of doxorubicin to a chemotherapy regimen of cisplatin and cyclophospamide used in the treatment of ovarian can cer and to integrate this with a previous meta-analysis that compared three year survival. Methods: Twenty-three studies that evaluated eith er the control or test arms were combined for meta-analysis. Five stud ies were randomized with both arms. Inclusion criteria consisted of me dian survival data, three year survival data, no previous chemotherapy or radiation and adequate follow-up. The data were analyzed with a tw o-tailed t test, a fixed effects odds ratio, a random effects odds rat io, logistic repression modelling for three year survival and standard regression modelling for median survival. Results: A statistically si gnificant improvement in three year survival was demonstrated with the fixed effects odds ratio analysis combining the five prospective rand omized studies and with logistic regression model of all the studies. Random effects odds ratio and the two-tailed t test failed to show sta tistical significance. Standard regression modelling demonstrated stat istically significant improvement in median survival for a doxorubicin dose intensity of 40 mg/m(2) and near significance for a doxorubicin dose intensity of 50 mg/m(2). Median survival was improved by 1.91 mon ths with the addition of doxorubicin to the cisplatin/cyclophosphamide regimen. Conclusion: Although there appears to be statistically signi ficant improvement in three year survival and median survival with the addition of doxorubicin to the cisplatin/cyclophoshamide regimen for ovarian cancer, the actual improvement in median survival is less than two months and therefore, the added toxicity of doxorubicin may not b e warranted.