| With intraperitoneal chemotherapy in the treatment of epithelial ovarian cancer in the application of in-depth study, the superior pharmacokinetic characteristics of the medical profession has been more and more recognized, but there are also some limitations and drawbacks.Compared with the traditional intravenous chemotherapy, intraperitoneal chemotherapy is more clinical value caused widespread concern in the medical profession, this clinic has launched a large number of randomized controlled trials, but often because of financial constraints and technical conditions, the number of the study samples is too small, resulting in lower test performance.Some may also be the same type of research, the results differ widely. Therefore, in ovarian cancer (especially for the epithelial ovarian cancer) in the reduction of satisfaction after surgery, intraperitoneal chemotherapy compared to intravenous chemotherapy, whether it can improve the survival rate and lower toxicity of chemotherapy after the incidence, the whole World gynaecologist the issues of greatest concern.Objective:The purpose of this paper aimed at the Meta-analysis methods, a number of previous independent, objective and true reflection of epithelial ovarian cancer after intraperitoneal chemotherapy and intravenous chemotherapy randomized controlled trials of the research findings, its survival rate and chemotherapy toxicity reaction rates, and other indicators of merger analysis, to evaluate the clinical efficacy differences of intraperitoneal chemotherapy and intravenous chemotherapy, for the treatment of patients with the choice of reference, for clinicians to provide evidence of clinical decision-making.Methods:This study used the method of system evaluation, collected published at home and abroad and has been registered but not yet published the epithelial ovarian cancer patients with tumor reduction surgery (postoperative residual tumor diameter <1 to 2 cm), and choose intraperitoneal chemotherapy and intravenous chemotherapy clinical trial research Meta-analysis of the literature. All the studies are in the test group for intraperitoneal chemotherapy to intravenous chemotherapy in the control group. Enacting strict inclusion and exclusion criteria. Take ovarian tumors, ovarian carcinoma, ovarian cancer as MeSH, intraperitoneal chemotherapy, intravenous chemotherapy as vice MeSH, since 1978, a comprehensive search Pubmed database, Medline database, Ovid database, Embase databases, China CJFD, China biomedical literature database, the WanFang database, China's outstanding master's degree thesis, full-text database, China's important conference papers, full-text database, China important newspapers, full-text database. Retrieval can be manually retrieved by the current reference and research reports, included in the original study, the quality of evaluations, extracting information and check. Finally, the study included meta-analysis. Researchers from two independent literature screening, the assessment of the quality of the article (by Jadad scale based on the score) and extraction of data.By the Cochrane Collaboration Revman 4.2 version of the selected clinical data processing and analysis of data during testing after the heterogeneity of the model and use appropriate methods, the use of the forest map generation software and the funnel plot merger of the statistics testing, sensitivity analysis and publication bias analysis. Heterogeneity of literature into a time (preferably on the results of a general description), or sensitivity analysis indicated that the results of instability, can not draw precise conclusions.Results:Search to a total of five clinical studies, including 1,229 cases of patients into the standard consistent with the literature, all the literature were high-quality research and mentioned blind law, but did not mention specific double-blind methods; All the literature were randomized controlled clinical trial, one mentioned the randomized sequence method for the formation,the other four did not mentioned; Both lost out to visit with the number of cases and the reasons for withdrawing a detailed description. Extracting data, Meta-analysis and descriptive analysis, the analysis results are as follows: Intraperitoneal chemotherapy and intravenous chemotherapy group compared: (1)2-year PFS increased (RR=1.16,95%CI[l.00,1.34], P=0.05), the difference was significant and precise conclusions can be drawn; (2)3-year PFS increased (RR=1.25,95%CI[l.02,1.54], P=0.03), the difference was significant and precise conclusions can be drawn; (3)5-year PFS increased (RR=1.24,95%CI[0.96,1.61], P=0.10), the difference was not statistically significant; (4)2-year OS increased (RR=1.09,95%CI[l.02,1.16],P=0.009), the difference was significant and precise conclusions can be drawn; (5)3-year OS increased (RR=1.10,95%CI[l.01,1.19], P=0.02), the difference was significant and precise conclusions can be drawn; (6)5-year OS increased(RR=1.21,95%CI[l.06,1.38], P=0.004), the difference was significant and precise conclusions can be drawn; (7) chemotherapy side effects of the six indicators, the occurrence of gastrointestinal reaction rate increased (RR=1.79,95%CI[l.36,2.37],P<0.0001), and the difference was significant and precise conclusions can be drawn; remaining five indicators had no statistical significance or precise conclusions can not be drawn.Conclusion:Meta-analysis of the adoption of this conclusion are as follows:1,Patients with epithelial ovarian cancer (FIGOâ…¡period ~â…£period) who had taken a satisfactory tumor reduction surgery (postoperative residual lesions <1 to 2 cm), the choice of intraperitoneal chemotherapy can improve their 2-year survival rate of no progress,3-year survival rate of no progress no progress, the 2-year overall survival rate,3-year overall survival rate and 5-year overall survival rate.2,Intraperitoneal chemotherapy has not declined the side effects as described in theory, but instead has increased the occurrence of gastrointestinal reaction rate.3,Through the Meta-analysis of the results, we can see that the intraperitoneal chemotherapy have better clinical results, although an increase of the gastrointestinal reaction rate, but other indicators related side effects had no significant difference.
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