| Objective:Ovarian cancer is one of the most common gynecological malignancies.At present,the outcomes of most of advanced epithelial ovarian cancer are clinical remission after surgery and intravenous/intraperitoneal chemotherapy with platinum-based drugs and paclitaxe,but most of the patients finally recrudesce.The greatest challenge in treatments is preventing the progression and recurrence of ovarian cancer.In recent years,Hyperthermic Intraperitoneal chemotherapy,a therapy combining intraperitoneal chemotherapy with hyperthermia,has been gradually applied in clinical practice.However,this technique has not been reported in this region.Our hospital began adopting Hyperthermic Intraperitoneal chemotherapy technology from 2018.This paper summarized the clinical application of Hyperthermic Intraperitoneal chemotherapy in the treatment of ovarian cancer.Method:Retrospective analysis was performed on patients with stage II-IV epithelial ovarian cancer in the Second Affiliated Hospital of Soochow University from August 2018 to October 2019.They all achieved R0/R1 resection.They were divided into two groups according to their treatment methods.The HIPEC group: patients were treated with Cytoreductive surgery,Hyperthermic Intraperitoneal chemotherapy and Intravenous chemotherapy.The control group: patients were treated with Cytoreductive surgery and Intravenous chemotherapy.We follow-up surveyed the patients by telephone and case review.Their general conditions,tumor markers,quality of life,complications,recurrence and survival were sorted out.Results:1.Basic information:A total of 36 patients were enrolled in the study.The HIPEC group: 16 patients were enrolled.(1)Reasons for visit: 8 patients were abdominal pain or abdominal distension,4 patients were abnormal vaginal bleeding and discharge,1 patient was fever and 3 patients were found on physical examination.(2)Mean age: 56.19 ± 9.59 years(40-74 years old).(3)Mean BMI: 24.17 ± 3.31 kg/m2.(4)11 patients were menopausal and 5 patients were not.(5)Mean QOL score: 42.31 ± 5.53 points.(6)Tumor diameter: 8.56 ± 3.10 cm.(7)CA125: 1599.71 ± 1584.38 U/ml.(8)HE4: 582.11 ± 260.36 pmol/L.(9)Tumor stage: stage II: 4 cases,stage III: 12 cases.(10)All of these cases were epithelial ovarian cancer proved by pathology.Type I: 3 cases,Type II: 13 cases.(11)Laparoscopic Cytoreductive surgeries were performed in 4 cases and laparotomy in 12 cases.(12)Residual disease: R0: 13 cases,R1: 3 cases.The control group: 20 patients were enrolled.(1)Reasons for visit: 13 patients were abdominal pain or abdominal distension,3 patients were abnormal vaginal bleeding and discharge and 4 patients were found on physical examination.(2)Mean age: 55.20 ± 8.95 years(35-68 years old).(3)Mean BMI: 23.91 ± 2.89 kg/m2.(4)13 patients were menopausal and 7 patients were not.(5)Mean QOL score: 43.10 ± 4.64 points.(6)Mean tumor diameter: 7.96 ± 3.67 cm.(7)CA125: 949.71 ± 1090.54 U/ml.(8)HE4: 430.90 ± 265.83 pmol/L.(9)Tumor stage: stage II: 2 cases,stage III: 16 cases,stage IV: 2 cases.(10)All of these cases were epithelial ovarian cancer proved by pathology.Type I: 5 cases,Type II: 15 cases.(11)Laparoscopic Cytoreductive surgeries were performed in 3 cases and laparotomy in 14 cases.(12)Residual disease: R0: 16 cases,R1: 4 cases.2.CA125: There was no statistically significant difference between the two groups.3.HE4: There was no statistically significant difference between the two groups.4.QOL score of patients was higher than before in these two groups.There was no statistically significant difference in QOL score between the two groups six months after the surgery,p=0.487.5.Complications: The HIPEC group: Grade I-II adverse reactions were found in 12 patients and grade III adverse reactions were found in 3 patients.The control group: Grade I-II adverse reactions were found in 12 patients and grade III adverse reactions were found in 8 patients.HIPEC didn’t result in the increasing incidence of adverse reactions,p>0.05.6.Follow up: The HIPEC group: Recurrent case: 4 cases,death case: none.The control group: Recurrent case: 8 cases,platinum resistant case: 3 cases,death case: none.There was no significant difference in recurrence rate between the two groups,p=0.481.Conclusions:For patients with ovarian cancer,postoperative Hyperthermic Intraperitoneal chemotherapy is a powerful supplement to treat ovarian cancer.It can improve the clinical symptoms and improve the quality of life without the increasing incidence of adverse reactions.However,this study is a retrospective study,and the sample size is relatively small,there may be a statistical bias.There was no difference in the recurrence rate,but there was a trend of decrease and there were no platinum resistant patients in HIPEC group,which needs to be further explored by a prospective study with large sample and long-term follow-up in the future. |
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