Running head: EVIDENCE-BASED PRACTICE GUIDELINE FOR ADMINISTRATION OF
CHEMOTHERAPY FOR TYPES II - IV OVARIAN CANCER
Evidence-Based Practice Guideline for Administration of Chemotherapy for Types II - IV Ovarian Cancer
Ovarian cancer is the seventh most common form of cancer in women today with some 140,000 new cases reported every year (AOCTG, 1999). Since the introduction of the antineoplastic platinum agent cisplatin in the 1970’s (CC, 2001), chemotherapy was generally accepted as the first-line treatment method for advanced carcinomas (Fung Kee Fung et al., 2002). However, several other chemotherapy drugs, such as carboplatin, doxorubicin and more recently paclitaxel, have been developed to combat ovarian cancer. From 1980 to the present, several randomized control trails (RCT) have tested the effects of the antineoplastic agents against varied control arms. In an effort to consolidate the information, the Advanced Ovarian Cancer Trialists Group (AOCTG) performed a major meta-analysis in 1991 (updated 1998) of all advanced ovarian cancer chemotherapy RCTs. It was not until July 2002 when the Cancer Care Ontario Practice Guidelines Initiative (CCOPGI) published the first guideline with recommendations for first-line chemotherapy treatment of advanced ovarian cancer. The goals of the authors, Fung Kee Fung, et. al., were to synthesize an unbiased evidence-based practice guideline for practitioners’ use. This paper is a critique of that guideline from a nursing perspective, as well as its correlation to the AOCTG’s meta-analysis.
The CCOPGI’s guideline is comprised of 30 individual RCTs, four meta-analyses with 34 total RCTs and one pooled set of data. Fung Kee Fung et al., evaluated the reports for increased patient survival, the schedule and dose administered of each drug, any adverse side effects and what combination of drugs yielded the best results....