热腹腔内化疗（HIPEC）治疗复发性卵巢癌：系统评价与荟萃分析
Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer recurrence: systematic review and meta-analysis.
作者信息
Cianci Stefano, Riemma Gaetano, Ronsini Carlo, De Franciscis Pasquale, Torella Marco, Schiattarella Antonio, La Verde Marco, Colacurci Nicola
机构信息
Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Gynecologic and Obstetrics Unit, Università "G. d'Annunzio", Chieti, Italy.
出版信息
Gland Surg. 2020 Aug;9(4):1140-1148. doi: 10.21037/gs-20-335.
BACKGROUND
Ovarian cancer is the first cause of death among gynecological malignancies with a high incidence of recurrence. Different treatment options are suitable to prolong the survival rate of these patients. Over the last years, one of the most intriguing methods, adopted in different oncologic centers worldwide, is the hyperthermic intraperitoneal chemotherapy (HIPEC).
METHODS
A meta-analysis was performed to value the role of HIPEC for ovarian cancer recurrence. Search strategy was conducted with a combination of the following keywords: "ovarian recurrence, ovarian cancer recurrence, peritoneal cancer recurrence, ovarian recurrence AND HIPEC, secondary cytoreduction HIPEC". Seven studies were selected for analysis.
RESULTS
In women with recurrent ovarian cancer (ROC), the use of HIPEC in addition to cytoreductive surgery and chemotherapy significantly improved 1-year overall survival (OS) when compared to protocols without HIPEC (OR 2.42; 95% CI, 1.06-5.56; P=0.04; I=4%). The improvement in OS was maintained significant also after 2, 3 and 5 years respectively (OR 3.33; 95% CI, 1.81-6.10; P<0.01; I=0%), (OR 4.22; 95% CI, 2.07-8.60; P<0.01; I=52%), (OR 5.17; 95% CI, 1.40-19.09; P=0.01; I=82%).
CONCLUSIONS
HIPEC seems to have an effective role to prolong survival in patients affected by ROC.
背景
卵巢癌是妇科恶性肿瘤中导致死亡的首要原因，复发率很高。不同的治疗方案适合延长这些患者的生存率。在过去几年中，全球不同肿瘤中心采用的最引人关注的方法之一是腹腔内热化疗（HIPEC）。
方法
进行一项荟萃分析以评估HIPEC对卵巢癌复发的作用。搜索策略是结合以下关键词进行的：“卵巢复发、卵巢癌复发、腹膜癌复发、卵巢复发与HIPEC、二次减瘤HIPEC”。选择了七项研究进行分析。
结果
在复发性卵巢癌（ROC）患者中，与未使用HIPEC的方案相比，在减瘤手术和化疗基础上使用HIPEC显著提高了1年总生存率（OS）（OR 2.42；95%CI，1.06 - 5.56；P = 0.04；I = 4%）。分别在2年、3年和5年后，OS的改善也保持显著（OR 3.33；95%CI，1.81 - 6.10；P < 0.01；I = 0%），（OR 4.22；95%CI，2.07 - 8.60；P < 0.01；I = 52%），（OR 5.17；95%CI，1.40 - 19.09；P = 0.01；I = 82%）。
结论
HIPEC似乎在延长ROC患者的生存方面具有有效作用。
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