化疗联合腹腔循环热灌注治疗恶性腹水疗效和安全性的Meta分析

目的 系统评价化疗联合腹腔循环热灌注治疗恶性腹水的疗效及安全性。方法 计算机检索Cochrane Library、MEDLINE、PubMed、Embase、中国生物医学期刊文献数据库(CBM)、维普期刊全文数据库、知网医学期刊数据库、万方数据库,同时辅以其他检索。按照纳入标准选择文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5.0.2软件进行Meta分析。结果 共纳入14个RCT,867例患者。Meta分析结果显示:化疗联合腹腔循环热灌注组(HIPEC)与化疗联合传统腹水治疗(CT)组相比,其完全缓解率、部分缓解率、总有效率(CR+PR)的差异均有统计学意义(完全缓解率:OR=3.18,95%CI:2.18~4.64,P＜0.00001;部分缓解率:OR=2.05,95%CI:1.51~2.77,P＜0.00001;总有效率:OR=4.88,95%CI:3.59~6.46,P＜0.00001);而HIPEC较CT组不良反应发生率的差异均无统计学意义。结论 化疗联合腹腔循环热灌注治疗能明显提高恶性腹水患者近期疗效,改善生活质量,毒副作用小,受限于纳入研究数量和质量,上述结论有待更多高质量大样本长期随访的研究予以验证。

Effect and safety of celiac continued circulatory hyperthermia perfusion with chemotherapy in the treat-ment of cancer with ascites Meta-analysis

Objective To evaluate the clinical efficacy and safety of celiac continued circulatory hyper -thermia perfusion with chemotherapy in the treatment of cancer with ascites .Methods Databases including the Cochrane Library MEDLINE,PubMed,Embase,CBM,VIP,CNKI and WanFang Data,and the other sources as supplying .The literatures were screened according to the inclusion criteria ,extracted data and assessed the meth-odological quality ,and then meta -analysis was performed using RevMan 5.0.2 software.Results Totally 14 RCTs with 867 patients were included .Meta-analysis showed that compared intraperitoneal chemotherapy ,with celiac continued circulatory hyperthermia perfusion had a significant difference in CR ( OR=3.18,95%CI:2.18~4.64,P<0.00001),PR(OR=2.05,95%CI:1.51~2.77,P<0.00001),overall effective rate(OR=4.88, 95%CI:3.59~6.46,P<0.00001).The incidence of adverse reactions was no statistically significant in the two groups.Conclusion Celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites demonstrates better efficacy and safety ,but it still needs to verify the above conclusion .