4 chemotherapy regimens for patients with advanced ovarian cancer

Chemotherapy is the most important adjuvant treatment for patients with advanced ovarian cancer. The 2011 Chinese version of the NCCN Guidelines recommends four preferred chemotherapy regimens for ovarian epithelial cancer, namely paclitaxel + cisplatin, paclitaxel + carboplatin, docetaxel + carboplatin, and weekly treatment with paclitaxel. Currently, the paclitaxel + carboplatin regimen is the most commonly used in clinical practice in my country.

The efficacy of these four chemotherapy regimens is basically similar, but due to side effects and practical operation reasons, the currently recognized first choice is still the monthly treatment of paclitaxel + carboplatin (TC), that is, regimen 2. This is because the acute toxicity caused by chemotherapy is less and milder. The main dose-limiting toxicity is hematological toxicity such as grade III/IV thrombocytopenia. The timely use of drugs that increase white blood cells and platelets can effectively control such side effects.

Although the efficacy of paclitaxel + cisplatin (TP) is the same as that of TC, it has more severe acute toxic reactions, such as nausea and vomiting, and a high incidence of irreversible side effects such as severe peripheral neuropathy, resulting in poor patient compliance. The hematological toxicity of docetaxel + carboplatin is more severe than that of TC, but since docetaxel has a milder peripheral neuropathy, it is generally used for patients with diabetes and other conditions that are more susceptible to neurotoxicity. Scheme 4, TC weekly treatment, is currently limited in scope because chemotherapy once a week conflicts with the current hospitalization required for chemotherapy in my country and the medical insurance reimbursement policy.