Efficacy and safety of traditional chemotherapies for patients with ovarian neoplasm: a network meta-analysis

// Lili Yang 1 , Gongliang Guo 2 , Liqun Sun 3 , Chenhao Li 4 and Haipeng Zhang 5 1 Department of Gynecology and Obstetrics, The First Hospital of Jilin University, Changchun, Jilin, China 2 Department of Cardiology, China Japan Union Hospital Jilin University, Changchun, Jilin, China 3 Outpatient Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, China 4 Department of Nephropathy, The First Hospital of Jilin University, Changchun, Jilin China 5 Department of Gynecology, The First Hospital of Jilin University, Changchun, Jilin, China Correspondence to: Haipeng Zhang, email: // Keywords : ovarian neoplasm, network meta-analysis, carboplatin, pegylated liposomal doxorubicin, paclitaxel Received : January 07, 2017 Accepted : February 24, 2017 Published : March 30, 2017 Abstract Background: Ovarian neoplasm is a kind of high risky cancer among female. This paper assessed the efficacy and safety of twelve therapies and figured out the superior chemotherapeutic drug for ovarian cancer through network meta-analysis (NMA). Method: Eligible randomized controlled trials (RCTs) were retrieved from electronic databases. Primary outcomes concerning efficacy, overall survival (OS) and progression-free survival (PFS), were presented as hazard ratio (HR) and the associated 95% credible interval( CrI ), while outcomes concerning safety were assessed by odds ratio (OR) and the corresponding 95% CrI . Surface under the cumulative ranking curve (SUCRA) was calculated under each survival and safety outcome in order to show the rankings of tested therapies. Result: Electronic databases such as PubMed and Embase were searched to finally obtain 19 eligible studies of 16290 patients. In accordance of primary outcomes, when it came to 3-y PFS, paclitaxel/epirubicin/carboplatin (Pa/E/Ca) and pegylated liposomal doxorubicin/ paclitaxel/ carboplatin (PLD/Pa/Ca) were preferred compared to carboplatin (Ca) (HR= 0.80, 95% CrI = 0.67-0.96; HR= 0.83, 95% CrI = 0.69-0.99). According to 5y-PFS, Pa/E/Ca was notably better than Ca (HR= 0.80, 95% CrI = 0.65-0.99). As to adverse effects, Ca was superior to Pa/E/Ca in neuropathy (HR=0.05, 95% CrI =0.02-0.19). Pa/E/Ca showed high rankings in 3y-PFS (SUCRA=0.749), 5y-OS (SUCRA=0.738) and 5y-PFS (SUCRA=0.798) while (PLD/Pa/Ca) in 3y-OS (SUCRA=0.737), 5y-OS (SUCRA=0.687) and 5y-PFS (SUCRA=0.712). Besides, Pa/E/Ca ranked the third with a SUCRA of 0.661 in neutropenia. Conclusion: PLD/Pa/Ca, PLD/Ca and Pa/E/Ca are highly recommended as potential therapeutically choices for patients with ovarian cancer. But considering the lack of safety data for PLD/Pa/Ca, this intervention should be taken with caution.