Effectiveness and Safety of Intraperitoneal Hyperthermic Perfusion Chemotherapy for Ovarian Cancer: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 CHAICheng-liang ,  WANGXiao-hui , CUIYan , SHIXiao-fang

Department of Gynecology and Obstetrics, First Hospital of Lanzhou University, Lanzhou 730000, China;

Corresponding?author：

WANGXiao-hui, Email: wxhwxh2006@163.com

Keywords：

Ovarian cancer; Intraperitoneal hyperthermic perfusion chemotherapy; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140201

Video：

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Objective To systematically review the effectiveness and safety of intraperitoneal hyperthermic perfusion chemotherapy (IHPC) for ovarian cancer, so as to provide references for clinical practice and studies. Methods We electronically searched PubMed, EMbase, The Cochrane Library (Issue 6, 2013), Web of Science, WanFang Data, CBM, VIP and CNKI for randomized controlled trials (RCTs) about IHPC vs. intravenous chemotherapy (IC) for ovarian cancer from the inception of the databases to June 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Then meta-analysis was performed using RevMan 5.1 software. Results A total of 10 RCTs involving 723 patients were included. The results of meta-analysis showed that the IHPC group was superior to the IC group in clinical efficiency (OR=4.02, 95%CI 2.85 to 5.68, P < 0.000 01), clinical benefit response (OR=3.41, 95%CI 2.13 to 5.45, P < 0.000 01), recurrence and metastasis rates (OR=0.29, 95%CI 0.20 to 0.42, P < 0.000 1), and overall survival rates (OR=3.30, 95%CI 1.82 to 5.99, P < 0.000 1). In the aspect of safety, no significant difference was found in bone marrow suppression, hemoglobin reduction, nausea and vomiting between two groups. Conclusion IHPC for ovarian cancer can improve clinical efficiency, clinical benefit response and overall survival rates, and reduce recurrence and metastasis rates; and it is also safe for patients.

Citation： CHAICheng-liang, WANGXiao-hui, CUIYan, SHIXiao-fang. Effectiveness and Safety of Intraperitoneal Hyperthermic Perfusion Chemotherapy for Ovarian Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(10): 1247-1253. doi: 10.7507/1672-2531.20140201 Copy

1.	Alberts DS, Hannigan EV, Liu P, et al. Randomized trial of adjuvant intraperitoneal alpha-interferon in stage Ⅲ ovarian cancer patients who have no evidence of disease after primary surgery and chemotherapy:An intergroup study. Gynecologic Oncology, 2006, 100(1):133-138.
2.	章偉玲, 林海英, 張玉泉.腹腔熱灌注化療在卵巢癌治療中的研究進展.中國婦幼健康研究, 2008, 19(5):491-494.
3.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
4.	周建煒, 呂銀祥, 王秋紅, 等.腹腔熱灌注聯合化療在卵巢漿液性囊腺癌初次術后中的應用探索.實用腫瘤雜志, 2010, 25(3):351-354.
5.	馮燕, 翟紅巖, 查斌斌, 等. 35例卵巢癌術后腹腔熱灌注化療臨床療效觀察.社區醫學雜志, 2009, 7(21):19-20.
6.	胡宗蘭, 曹軍麗, 顧濤, 等.腹腔熱灌注化療聯合全身化療在卵巢癌惡性腹腔積液控制中的近期療效.山東醫藥, 2009, 49(40):42-43.
7.	任春振, 曹軍麗, 胡宗蘭, 等.腹腔熱灌注化療聯合靜脈化療治療晚期卵巢癌的臨床觀察.中國腫瘤臨床, 2010, 37(24):1459-1461.
8.	吳素芳, 謝優優, 陳佩芳.重組人血管內皮抑制素聯合靜脈化療和腹腔熱灌注化療治療晚期卵巢癌的臨床研究.中國醫師進修雜志, 2013, 36(3):10-13.
9.	李小瑞, 楊軍, 孫蔚亮, 等.腹腔灌注及靜脈化療配合熱療治療晚期卵巢癌的臨床觀察.醫學信息內·外科版, 2009, 22(2):131-132.
10.	梁冰, 楊家梅, 賀新偉.全身化療聯合腹腔熱灌注化療并射頻熱療治療晚期卵巢癌.醫藥論壇雜志, 2009, 30(24):57-58.
11.	陳紅娜, 王海增.腹腔持續熱化療治療卵巢癌腹水的療效與Ca125的相關性研究.中國醫藥導報, 2009, 11(6):903-904.
12.	王秀清, 方獻英, 柏峰.晚期卵巢癌術后早期順鉑腹腔熱灌注化療臨床研究.現代腫瘤醫學, 2011, 19(10):2061-2063.
13.	梁云芳.雙化療途徑治療卵巢癌的臨床療效分析.中國醫師雜志, 2011, 02(z2):82-83.
14.	Vasey PA, Herrstedt J, Jelic S. ESMO Guidelines Task Force:ESMO minimum clinical recommendations for diagonosis, treatment and follow-up of epithelial ovarian carcinoma. Ann Oncol, 2005, 16(suppl 1):i13-i15.
15.	Sugarbaker PH. Peritoneal cardnomatosis:natural history and rational therapeutic interventions using intraperitoneal chemotherapy. Cancer Treat Res, 1996, 81(2):149-168.
16.	Zanon C, Clara R, Chiappino I, et al. Cytoreductive surgery and intraperitoneal chemohyperthexmia for recurrent peritoneal carcinomatosis from ovarian cancer. World J Surg, 2004, 28(10):1040-1045.
17.	Lentz SS, Miller BE, Kucera GLK, et al. Intraperitoneal hypertherrmic chemotherapy using carboplatin:A phase I analysis in ovarian carcinoma. Gynecol Oncol, 2007, 106(1):207-210.
18.	羅奮, 沈敏, 蔡端.腹腔溫熱化療研究現狀和進展.國外醫學腫瘤學分冊, 2001, 28(2):152-153.
19.	Stewart JH, Shen P, Levine EA. Intraperitoneal hyperthermic chemotherapy for peritoneal surface malignancy:Current status and future directions. Arm Sttrg Oncol, 2005, 12(10):765-777.
20.	Glehen O, Kwintkowski F, Sugarbaker PH, et al. Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal Cancer:a multi-institutional study. J Clin Oncol, 2004, 22(16):3284-3292.

1. Alberts DS, Hannigan EV, Liu P, et al. Randomized trial of adjuvant intraperitoneal alpha-interferon in stage Ⅲ ovarian cancer patients who have no evidence of disease after primary surgery and chemotherapy:An intergroup study. Gynecologic Oncology, 2006, 100(1):133-138.
2. 章偉玲, 林海英, 張玉泉.腹腔熱灌注化療在卵巢癌治療中的研究進展.中國婦幼健康研究, 2008, 19(5):491-494.
3. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
4. 周建煒, 呂銀祥, 王秋紅, 等.腹腔熱灌注聯合化療在卵巢漿液性囊腺癌初次術后中的應用探索.實用腫瘤雜志, 2010, 25(3):351-354.
5. 馮燕, 翟紅巖, 查斌斌, 等. 35例卵巢癌術后腹腔熱灌注化療臨床療效觀察.社區醫學雜志, 2009, 7(21):19-20.
6. 胡宗蘭, 曹軍麗, 顧濤, 等.腹腔熱灌注化療聯合全身化療在卵巢癌惡性腹腔積液控制中的近期療效.山東醫藥, 2009, 49(40):42-43.
7. 任春振, 曹軍麗, 胡宗蘭, 等.腹腔熱灌注化療聯合靜脈化療治療晚期卵巢癌的臨床觀察.中國腫瘤臨床, 2010, 37(24):1459-1461.
8. 吳素芳, 謝優優, 陳佩芳.重組人血管內皮抑制素聯合靜脈化療和腹腔熱灌注化療治療晚期卵巢癌的臨床研究.中國醫師進修雜志, 2013, 36(3):10-13.
9. 李小瑞, 楊軍, 孫蔚亮, 等.腹腔灌注及靜脈化療配合熱療治療晚期卵巢癌的臨床觀察.醫學信息內·外科版, 2009, 22(2):131-132.
10. 梁冰, 楊家梅, 賀新偉.全身化療聯合腹腔熱灌注化療并射頻熱療治療晚期卵巢癌.醫藥論壇雜志, 2009, 30(24):57-58.
11. 陳紅娜, 王海增.腹腔持續熱化療治療卵巢癌腹水的療效與Ca125的相關性研究.中國醫藥導報, 2009, 11(6):903-904.
12. 王秀清, 方獻英, 柏峰.晚期卵巢癌術后早期順鉑腹腔熱灌注化療臨床研究.現代腫瘤醫學, 2011, 19(10):2061-2063.
13. 梁云芳.雙化療途徑治療卵巢癌的臨床療效分析.中國醫師雜志, 2011, 02(z2):82-83.
14. Vasey PA, Herrstedt J, Jelic S. ESMO Guidelines Task Force:ESMO minimum clinical recommendations for diagonosis, treatment and follow-up of epithelial ovarian carcinoma. Ann Oncol, 2005, 16(suppl 1):i13-i15.
15. Sugarbaker PH. Peritoneal cardnomatosis:natural history and rational therapeutic interventions using intraperitoneal chemotherapy. Cancer Treat Res, 1996, 81(2):149-168.
16. Zanon C, Clara R, Chiappino I, et al. Cytoreductive surgery and intraperitoneal chemohyperthexmia for recurrent peritoneal carcinomatosis from ovarian cancer. World J Surg, 2004, 28(10):1040-1045.
17. Lentz SS, Miller BE, Kucera GLK, et al. Intraperitoneal hypertherrmic chemotherapy using carboplatin:A phase I analysis in ovarian carcinoma. Gynecol Oncol, 2007, 106(1):207-210.
18. 羅奮, 沈敏, 蔡端.腹腔溫熱化療研究現狀和進展.國外醫學腫瘤學分冊, 2001, 28(2):152-153.
19. Stewart JH, Shen P, Levine EA. Intraperitoneal hyperthermic chemotherapy for peritoneal surface malignancy:Current status and future directions. Arm Sttrg Oncol, 2005, 12(10):765-777.
20. Glehen O, Kwintkowski F, Sugarbaker PH, et al. Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal Cancer:a multi-institutional study. J Clin Oncol, 2004, 22(16):3284-3292.

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Effectiveness and Safety of Intraperitoneal Hyperthermic Perfusion Chemotherapy for Ovarian Cancer: A Systematic Review

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