Docetaxel versus paclitaxel for adjuvant treatment of ovarian cancer - Case-control analysis of toxicity

The objective of this study was to evaluate the toxicity profile of docetaxel/carboplatin versus paclitaxel/carboplatin. All patients with primary ovarian, fallopian tube, or peritoneal malignancies treated with docetaxel and platinum at the University of Iowa between January 1996 and June 1999 were identified. Controls, treated with paclitaxel and platinum, were matched for age, date of diagnosis, type of cancer, stage, and residual disease. Toxicity was evaluated prior to each cycle and was graded according to the Gynecologic Oncology Group criteria. Twenty patients were identified in each group and evaluated. In the docetaxel/carboplatin group, sixteen (80%) patients experienced hematologic toxicity. Nine (45%) bad grade III or IV neutropenia and fever developed in two of these patients. Grade III or IV thrombocytopenia developed in two patients. In contrast, among the paclitaxel/carboplatin group, grade III or IV neutropenia developed in only three patients (p < 0.05) and grade III or IV thrombocytopenia developed in two patients. There were no significant differences between the two groups with regard to gastrointestinal or renal toxicity. In the paclitaxel/carboplatin group, 13 patients developed neuropathy compared to only 2 patients (10%) in the docetaxel/carboplatin group (p < 0.05). There was no difference in the clinical response between the two treatment groups. In conclusion, neutropenia was more common with the docetaxel/carboplatin regimen, whereas neuropathy was more common in the paclitaxel-based regimen. The therapeutic efficacy was equivalent between the two groups.