Tang Qin, Huang Mao, Zhang Jing, Huang Zhen, Wang Linlian, Gong Zhengxin, Tang Liangdan
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
J Clin Med. 2023 Jan 31;12(3):1111. doi: 10.3390/jcm12031111.
We aimed to compare the survival outcomes and adverse events of hyperthermic intraperitoneal chemotherapy (HIPEC), intraperitoneal chemotherapy (IP)and intravenous chemotherapy (IP)for primary advanced ovarian cancer.
PubMed, CENTRAL (Cochrane Central Registry of Controlled Trials), Embase, Web of Science and Scopus were searched using multiple terms for primary advanced ovarian cancer, including randomized controlled trials and comparative studies in both Chinese and English (up to date 15 August 2022). Outcomes include overall survival, progression-free survival and adverse events. The data were pooled and reported as hazard ratio (HRs) with 95% confidence intervals. The Newcastle-Ottawa Scales were used to assess the risk of bias in the included comparative study. The Cochrane Collaboration's Risk of Bias Tool was used for randomized controlled trials.
In total, 32 studies, including 6347 patients and 8 different platinum-based chemotherapy regimens, were included in this network meta-analysis. Our analysis results showed that HIPEC2 (carboplatin with area under the curve 10) exhibited a statistically significant OS benefit compared to IV, weekly dose-dense chemotherapy and HIPEC1 (cisplatin with 75/100 mg/m). Intraperitoneal plus intravenous chemotherapy was associated with a statistically significantly better likelihood of overall survival compared to IV. For progression-free survival, our statistical results only suggest a better progression-free survival in ovarian cancer patients treated with HIPEC1 compared with weekly dose-dense chemotherapy. No evidence of difference was observed between the other comparison groups. Compared with the non-HIPEC group, HIPEC may had a higher incidence of electrolyte disturbances (≥grade 3).
Our statistical analysis suggests that the groups receiving HIPEC2 had a better OS than the groups receiving IV, weekly dose-dense chemotherapy and HIPEC1. For PFS, our analysis only showed HIPEC1 is better than IV. Moreover, HIPEC may lead to a higher incidence of electrolyte disturbances (≥grade 3). HIPEC therapy for advanced ovarian cancer is currently controversial.
我们旨在比较热灌注腹腔化疗（HIPEC）、腹腔内化疗（IP）和静脉化疗（IV）治疗原发性晚期卵巢癌的生存结局和不良事件。
使用多个检索词在PubMed、CENTRAL（Cochrane对照试验中心注册库）、Embase、Web of Science和Scopus中检索原发性晚期卵巢癌相关文献，包括中英文的随机对照试验和比较研究（截至2022年8月15日）。结局指标包括总生存期、无进展生存期和不良事件。数据进行汇总并报告为风险比（HRs）及95%置信区间。采用纽卡斯尔-渥太华量表评估纳入的比较研究中的偏倚风险。对随机对照试验使用Cochrane协作网偏倚风险工具。
本网络荟萃分析共纳入32项研究，包括6347例患者和8种不同的铂类化疗方案。我们的分析结果显示，与静脉化疗、每周剂量密集化疗和HIPEC1（顺铂75/100mg/m）相比，HIPEC2（卡铂曲线下面积为10）在总生存期方面具有统计学显著优势。与静脉化疗相比，腹腔内联合静脉化疗在总生存可能性方面具有统计学显著更好的结果。对于无进展生存期，我们的统计结果仅表明，与每周剂量密集化疗相比，接受HIPEC1治疗的卵巢癌患者无进展生存期更好。其他比较组之间未观察到差异证据。与非HIPEC组相比，HIPEC可能有更高的电解质紊乱发生率（≥3级）。
我们的统计分析表明，接受HIPEC2治疗的组比接受静脉化疗、每周剂量密集化疗和HIPEC1治疗的组总生存期更好。对于无进展生存期，我们的分析仅显示HIPEC1优于静脉化疗。此外，HIPEC可能导致更高的电解质紊乱发生率（≥3级）。晚期卵巢癌的HIPEC治疗目前存在争议。
