The Clinical Efficacy and Safety of Paclitaxel in Adjuvant Therapy of Breast Cancer: A Systematic Review and Meta-Analysis

Abstract

 Purpose: To systematically review the clinical efficacy and adverse reactions of Paclitaxel for the treatment of mammary cancer.

Math: We searched Web of knowledge, PubMed, VIP information and CNKI (to October 2013) on randomised controlled trial about Paclitaxel for the treatment of mammary cancer and retrieved relevant reference and research material by hand. Two authors independently screened document, extracted data and assessed the quality according to inclusion and exclusion criteria, we finally used the software RevMan 5.2 from Cochrane for Meta-analysis.

Result: 18 randomized controlled clinical study were brought into our study according to inclusion and exclusion criteria, including 10712 patients. The result of meta-analysis showed that the odds ratios of Paclitaxel for adjunctive therapy [OR = 1.64, 95% CI (1.40, 1.92), P <0.00001] was better than conventional drugs, while the overall survival was no significant difference between Paclitaxel and conventional drugs. The further Subgroup analysis showed that the efficacy of Paclitaxel for adjunctive therapy was better than cyclophosphamide [OR = 1.41, 95%C I (1. 07, 1.85), P =0. 01] and NVB [OR = 2.10, 95% CI (1.33, 3.30), P =0.001]. The adverse reactions analysis results showed the ratio of myelosuppression and alopecia by treated with Paclitaxel was improved, while the occurrence of gastrointestinal reaction rate was decreased.

Conclusion: The current evidence showed Paclitaxel was effective for the adjuvant treatment of breast cancer, but the above conclusions still need future expansion of more samples, high quality RCT verify.

Keyword: Paclitaxel, Breast cancer, efficacy, adverse reactions, systematically review, Meta-analysis, randomized controlled trial.