title: Topotecan plus carboplatin and paclitaxel in first-line treatment of advanced ovarian cancer: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To evaluate whether the addition of topotecan can improve the efficacy of carboplatin and paclitaxel in first-line treatment of advanced epithelial ovarian cancer.
  
  
  METHODS
  Meta-analysis was performed using a random effects model.
  
  
  RESULTS
  Four randomized controlled trials with a total of 3632 patients were identified and included in the meta-analysis. No significant differences were observed in terms of progression-free survival (P=0.400), overall survival (P=0.502) and overall response rate (P=0.953) between patients treated with topotecan plus carboplatin and paclitaxel versus carboplatin and paclitaxel. However, there were significantly higher rates of grade 3-4 leucopenia (P=0.024), neutropenia (P<0.001), anaemia (P<0.001), and thrombopenia (P<0.001) in the topotecan plus carboplatin and paclitaxel group. No significant differences were observed in grade 3-4 nausea (P=0.352) and vomiting (P=0.092) between these two groups.
  
  
  CONCLUSIONS
  Topotecan plus carboplatin and paclitaxel did not improve survival outcomes and caused more haematological toxicity for advanced ovarian cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Jia
authors.forename: Yintao
authors.initials: Y
authors.lastname: Xu
authors.forename: Xun Clare
authors.initials: XC
authors.lastname: Zhou
authors.forename: Beihua
authors.initials: B
authors.lastname: Kong
authors.forename: Dadong
authors.initials: D
authors.lastname: Li
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D019772:Topotecan / Q000008:administration & dosage
chemical_list: D019772:Topotecan; D016190:Carboplatin; D017239:Paclitaxel