A Meta-analysis Of Hyperthermic Intraperitoneal Perfusion Chemotherapy Followed By Intravenous Chemotherapy For Advanced Colorectal Cancer After Radical Resection

Objective:This study summarized the efficacy and safety of Hyperthermic Intraperitoneal Perfusion Chemotherapy(HIPEC)followed by Intravenous Chemotherapy(IC)for advanced colorectal cancer published in recent years,and evaluated its efficacy and safety by Meta analysis.Methods:Through a comprehensive search of four English databases such as PubMed,Embase,Cochrane and Medline,and three Chinese databases such as China Knowledge Network,Wanfang Data Knowledge Service Platform and China Biomedical Literature Database,the relevant literatures about Hyperthermic Intraperitoneal Perfusion Chemotherapy followed by Intravenous Chemotherapy for advanced colorectal cancer were collected and analyzed.To compare the short-term and long-term efficacy,adverse reactions and postoperative complications of Hyperthermic Intraperitoneal Perfusion Chemotherapy followed by Intravenous Chemotherapy with intravenous chemotherapy alone in the treatment of advanced colorectal cancer.to evaluate the efficacy and safety of this.Through the establishment of literature inclusion and exclusion criteria,strictly abide by the criteria to select and include the literatures,evaluate the quality of the included literatures,extract the relevant analysis data,and import the RevMan5.3 software provided by the Cochrane Collaboration Network for data analysis.The 1-,2-,3-and 5-year survival rates,local recurrence and distant metastasis,toxic reactions of related chemotherapeutic drugs(nausea and vomiting,myelosuppression,liver and kidney function damage,neurotoxicity),postoperative complications(anastomotic and stump fistula,intestinal obstruction,abdominal infection)of the experimental group and the control group were analyzed by meta.Results:1.A total of 13 articles were included after screening.There were 1374 patients,667 patients in the experimental group(HIPEC+IC group)and 707 patients in the control group(IC group).There was no significant difference in gender and age between two groups.2.Meta analysis results:1.Therapeutic effect:the 1-,2-,3-and 5-year survival rates in the HIPEC+IC group were higher than those in the IC group,while the local recurrence rate and distant metastasis rate were lower than,and the differences were statistically significant(all P<0.05).It shows that HIPEC+IC can effectively prolong the survival time of patients and reduce the incidence of local recurrence and distant metastasis.2.toxicity of chemotherapeutic drugs:there was no significant difference in nausea and vomiting,myelosuppression,neurotoxicity,liver function damage and renal function damage between the HIPEC+IC group and the IC group.It is suggested that HIPEC+IC does not increase the toxicity of related chemotherapeutic drugs in patients.3.postoperative complications:there was no significant difference in the incidence of anastomotic fistula and stump fistula,intestinal obstruction and abdominal infection between the HIPEC+IC group and the simple IC group.The results showed that HIPEC+IC did not increase the incidence of postoperative complications.Conclusion:Compared with IC alone,HIPEC followed by IC therapy for advanced colorectal cancer can significantly prolong the 1-,2-,3-and 5-year survival rates of patients with advanced colorectal cancer,significantly reduce the incidence of local recurrence and distant metastasis,and do not increase the toxicity of chemotherapeutic drugs and postoperative complications.It shows that HIPEC followed by IC is effective and safe in the treatment of advanced colorectal cancer.