腹腔内化疗对晚期卵巢癌影响的Meta分析

A Meta-analysis of the effect of intraperitoneal chemotherapy on advanced ovarian cancer

目的通过对比腹腔内化疗和静脉化疗对晚期卵巢癌患者术后预后及生存期的影响,探讨腹腔内化疗在卵巢癌中的应用。方法计算机检索Pubmed、知网、万方,年限为1990年1月1日至2017年3月31日,纳入已行满意的肿瘤细胞减灭术后接受腹腔内化疗与静脉化疗的随机对照试验或观察性研究。结果最终纳入5篇文献,共2 881例患者。Meta分析结果显示:腹腔内化疗组(IP组)较静脉化疗组(IV组)能延长晚期卵巢癌患者无进展生存期和总生存期(P<0.05)。两组患者血小板减少、肾脏毒性及消化道毒副作用发生率差异显著(P<0.05),白细胞减少、贫血、神经毒性发生率比较,差异不具有统计学意义(P>0.05)。结论腹腔内化疗可以减少晚期卵巢癌患者消化道反应,增加血小板及肾脏毒性的发生率,提高患者无进展生存期与总生存期。

Objective To explore the application of intraperitoneal chemotherapy in ovarian cancer by comparing the effects of intraperitoneal chemotherapy and intravenous chemotherapy on postoperative prognosis and survival of patients.Methods The literature published from January 1, 1990 to March 31, 2017 in Pubmed, CNKI and Wan Fang were searched.Randomized controlled trials or observational studies between intraperitoneal chemotherapy and intravenous chemotherapy after performing a satisfactory tumor cell subtraction were selected. Results Five articles were eventually included and 2 881 patients were enrolled. The results of Meta-analysis show that： the IP group could improve the progression-free survival and overall survial in patients with advanced ovarian cancer than the IV group（P〈0.05）. The differences in the incidences of thrombocytopenia, renal toxicity and digestive tract were significant（P〈0.05）. The differences in the incidence of leukopenia, anemia and neurotoxicity were not significant（P〉0.05）. Conclusion Intraperitoneal chemotherapy can reduce the gastrointestinal reactions and increase the incidence of platelet and renal toxicity in patients with advanced ovarian cancer, it can significantly improve the patients＇ progression-free survival and overall survival.