腹腔热灌注化疗治疗进展期结直肠癌临床疗效及安全性的Meta分析

Meta-Analysis of Clinical Efficacy and Safety about Hyperthermic Intraperitoneal Perfusion Chemotherapy in Treatment of Advanced Colorectal Cancer

目的探讨腹腔热灌注化疗(hyperthermic intraperitoneal perfusion chemotherapy,HIPC)治疗进展期结直肠癌的临床疗效和安全性。方法应用Meta分析的方法对国内、外已发表的8篇随机对照研究的文献进行定量综合,以结直肠癌根治术后行HIPC治疗的患者为治疗组,以仅施行结直肠癌根治术的患者为对照组,比较2组患者5年生存率和3年生存率的结局变量的相对危险度(RR)及安全性。结果入选的8篇文献共1501例患者,其中治疗组765例,对照组736例,5年生存率的RR为2.39(95%CI:1.66～3.45);3年生存率的RR为2.13(95%CI:1.45～3.13),提示HIPC可提高结直肠癌患者5年和3年生存率,敏感性分析证实该结论较为可靠。入选的5篇文献对HIPC的安全性进行了描述,结果表明HIPC的潜在安全问题较小。结论进展期结直肠癌根治术后行HIPC可以提高生存率,改善患者的预后;是否会增加患者术后并发症发生率目前缺乏相关性研究,尚无明确的结论 。

Objective To investigate the clinical efficacy and safety of hyperthermic intraperitoneal perfusion chemotherapy （HIPC） in treatment of advanced colorectal cancer.Methods The Meta-analysis was applied to analyze 8 randomized controlled quantitative studies published at domestic and abroad.These patients treated by HIPC after radical operation with colorectal cancer were included for the treatment group,and those treated only by radical operation with colorectal cancer for the control group.Relative risk （RR） of outcome variable of 3-year and 5-year survival rate and safety between the two groups were compared.Results There were 8 selected literatures,including 1 501 cases,in which 765 cases for treatment group,and 736 cases for control group.RR of 5-year survival rate of the total patients was 2.39 （95% CI：1.66-3.45）.RR of 3-year survival rate of the total patients was 2.13 （95% CI：1.45-3.13）.The results demonstrated that HIPC could improve 5-year and 3-year survival rate,and sensitivity analysis confirmed the conclusions more reliable.The security was described in 5 literatures,the available information showed smaller potential security issue.Conclusions HIPC after radical operation of advanced colorectal cancer can increase 5-year and 3-year survival rate of patients,improve the prognosis of patients.Whether patients with increased incidence of postoperative complications related to the HIPC is no clear-cut conclusions for lack of related research.