Meta Analysis Of Perioperative Peritoneal Hyperthermia Chemotherapy In The Treatment Of Ovarian Cancer

Objective : to evaluate the efficacy of intraperitoneal hyperthermic infusion chemotherapy combined with intravenous chemotherapy in the treatment of ovarian cancer during the perioperative period of rumor cell reduction by meta analysis.To evaluate the efficacy and safety of intraperitoneal hyperthermic infusion chemotherapy combined with total vein in the treatment of ovarian cancer.Methods: the Chinese database: China Weipu database,Chinese knowledge network database,Chinese biomedical literature service system database,Wan fang medical database,Baidu academic database;To search the foreign language database:pubmed database,The Cochrane Library database,Web Of Science database and so on,about the randomize controlled trial of intraperitoneal hyperthermic infusion chemotherapy combined with intravenous chemotherapy in the perioperative period of tumor cell reduction.no language type is set during retrieval.Establish inspection according to "P I C O S" principle search strategy.and through the local library to consult the relevant subject journals,books and through inter-library loan channels to find the relevant literature materials,the search time until November 2018.The literature was screened independently by two researchers according to the inclusion and exclusion criteria and the Chchrane system Evaluation Manual 5.1.1(Cochrane Reviewer's Handbook 5.1.1,respectively.meta Analysis using Rev Man(Review Manager)5.3 Analysis provided by Cochrane Cooperative Network SoftwareResults: through literature screening,a total of 19 articles were included in the study.There were 1667 subjects in the study group,1667 in the experimental group and 827 in the control group.meta analysis results:Survival rate: the overall survival rate(OR=3.11,)of patients with ovarian cancer can be improved by intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy during the perioperative period of tumor cell reductioncompared with simple systemic intravenous chemotherapy combined with tumor cell reduction.95 CI: 1.88-5.16),but also can improve the short-term survival rate [1-year survival rate(OR=2.13,95%CI:1.41-3.22),3-year survival rate(OR=3.49,95%CI1.97-6.18)],Long term survival rate [4 years survival rate(OR=2.59,95%CI)]The 5-year survival rate(OR=2.59,95%CI:1.69-3.97)was significantly different(P <0.05).Effective rate,recurrence rate: perioperative intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy can reduce the recurrence rate(OR=0.21,)of patients compared with systemic intravenous chemotherapy and tumor cell reduction.The difference of 95%CI:0.10-0.45 and OR=2.59,95%CI:1.89-3.57 was statistically significant(p < 0.05).Adverse reactions and complications: intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy was performed during the perioperative period of tumor cell reduction,compared with simple systemic intravenous chemotherapy combined with tumor cell reduction.Can improve or reduce adverse reactions and complications: digestive tract reaction and ascites control rate(OR=1.52,95%CI:1.15-2.00;)OR=2.75,95%CI:1.69-4.47),there was no significant difference(p > 0.05).The adverse reactions and complications were thrombocytopenia,hemoglobin reduction,peripheral neurotoxicity and cardiac toxicity.Bone marrow transplantation Hair(OR=0.72,95%CI:0.54-1.73;OR=0.86,95%CI:0.52-1.43;OR=1.36,95%CI:0.71-2.60;OR=0.74,95%CI:0.28-1.96;OR=1.11,95%CI:0.82-1.50;OR=0.90,95%CI:0.61-1.32),the difference was statistically Significant(p > 0.05).Subgroup analysis: according to the different regions included in the study,the time of intraperitoneal hyperthermic infusion chemotherapy was different,and the nature of the disease was different.During the perioperative period of tumor cell reduction,intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy was performed in comparison with systemic intravenous chemotherapy combined with tumor cell reduction.All the studies had statistical differences except for the subgroup analysis(OR=2.57,95%CI:1.13-5.86,p=0.02)with 4 year survival rate as the outcome index.Conclusion: peritoneal hyperthermic chemotherapy combined with intravenous chemotherapy during the perioperative period of tumor cell reduction can improve the short and long term survival rate and the total effective rate compared with systemicintravenous chemotherapy alone and tumor cell reduction.Reduce the recurrence rate.In controlling adverse reactions and complications,During the perioperative period of tumor cell reduction,intraperitoneal hyperthermic infusion chemotherapy combined with intravenous chemotherapy and simple systemic intravenous chemotherapy combined with tumor cell reduction could reduce the adverse reactions of digestive tract and control the occurrence of ascites in patients,but the thrombocytopenia was associated with thrombocytopenia.Hemoglobin decrease,peripheral neurotoxicity,cardiac toxicity,alopecia and other adverse reactions or complications Intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy can not control or alleviate the adverse reactions and complications.Therefore,intraperitoneal hyperthermic infusion chemotherapy combined with intravenous chemotherapy in the perioperative period of tumor cell reduction is effective in the treatment of ovarian cancer without increasing the risk of adverse reactions,high efficiency,safety,feasibility and reliability.