进展期胃癌术后腹腔热灌注化疗有效性和安全性的系统评价

目的系统评价进展期胃癌术后腹腔热灌注化疗(intraperitoneal hyperthermic perfusion chemotherapy,IHPC)的疗效及安全性,为临床应用与深入研究提供参考。方法计算机检索Cochrane Library、PubMed、EMbase和中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库、数字化期刊全文数据库,同时辅以其他检索。收集所有比较进展期胃癌术后IHPC与术后单纯静脉全身化疗(intravenous chemotherapy,IC)的随机对照试验(RCT)。参考Cochrane系统评价手册5.1的质量评价标准对纳入文献进行质量评价后,使用RevMan 5.1软件进行Meta分析。结果共纳入18个RCT,2?299例患者。Meta分析结果显示:IHPC组与IC组相比,两组的1、2、3、5年生存率,3、5年复发率及3、5年远处转移率差异均有统计学意义,其OR(95%CI)分别为1.88(1.49,2.39)、2.45(1.64,3.67)、2.29(1.92,2.73)、2.17(1.70,2.76)、0.39(0.29,0.52)、0.54(0.40,0.72)、0.55(0.38,0.78)、0.58(0.42,0.81)。在安全性方面,两组脱发、肠梗阻、骨髓抑制及肝脏损害发生率的差异无统计学意义;而腹痛、腹胀及恶心呕吐发生率的差异均有统计学意义,其OR(95%CI)分别为2.20(1.58,3.07)、7.00(2.67,18.36)和0.65(0.45,0.95)。结论相比单纯IC疗法,进展期胃癌术后IHPC+IC双途径疗法可降低术后复发率和远处转移率,提高患者远期生存率并且安全性可以接受,推荐结合患者具体情况进行临床应用。

Intraperitoneal Hyperthermic Perfusion Chemotherapy for Postoperative Advanced Gastric Cancer: A Systematic Review

Objective To evaluate the e ectiveness and safety of postoperative intraperitoneal hyperthermic per-fusion chemotherapy(IHPC) for advanced gastric cancer,so as to provide references for clinical practice and study.Methods e following databases including e Cochrane Library,PubMed,EMbase,CBM,CNKI,VIP and WanFang were searched on computer,and other searches were also performed to collect all relevant randomized controlled trials(RCTs) on postoperative IHPC versus intravenous chemotherapy alone(IC) for advanced...