化疗联合腹腔循环热灌注治疗恶性腹水疗效和安全性的Meta分析

doi:10.11904/j.issn.1002-3070.2016.04.013

实用肿瘤学杂志 ›› 2016, Vol. 30 ›› Issue (4): 356-364.doi: 10.11904/j.issn.1002-3070.2016.04.013

化疗联合腹腔循环热灌注治疗恶性腹水疗效和安全性的Meta分析

闫向勇¹,燕忠生¹,刘文超²,丁辉¹

1.兰州军区兰州总医院中医科(兰州 730050);
2.第四军医大学西京医院肿瘤中心

收稿日期:2016-04-19 出版日期:2016-08-10 发布日期:2016-08-19
通讯作者: 燕忠生,E-mail:yanzs1968@163.com
作者简介:闫向勇,男,(1980-),硕士,主治医师,从事恶性肿瘤综合治疗的研究

Effect and safety of celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites Meta-analysis

YAN Xiangyong¹,YAN Zhongsheng¹,LIU Wenchao²,DING Hui¹

1.Department of Integrative Medicine,Lanzhou Military Region General Hospital,Lanzhou 730050,China;
2.Department of Clinical Oncology,Xijing Hospital,Fourth Military Medical University

Received:2016-04-19 Online:2016-08-10 Published:2016-08-19

摘要/Abstract

摘要： 目的系统评价化疗联合腹腔循环热灌注治疗恶性腹水的疗效及安全性。方法计算机检索Cochrane Library、MEDLINE、PubMed、Embase、中国生物医学期刊文献数据库(CBM)、维普期刊全文数据库、知网医学期刊数据库、万方数据库,同时辅以其他检索。按照纳入标准选择文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5.0.2软件进行Meta分析。结果共纳入14个RCT,867例患者。Meta分析结果显示:化疗联合腹腔循环热灌注组(HIPEC)与化疗联合传统腹水治疗(CT)组相比,其完全缓解率、部分缓解率、总有效率(CR+PR)的差异均有统计学意义(完全缓解率:OR=3.18,95%CI:2.18~4.64,P＜0.00001;部分缓解率:OR=2.05,95%CI:1.51~2.77,P＜0.00001;总有效率:OR=4.88,95%CI:3.59~6.46,P＜0.00001);而HIPEC较CT组不良反应发生率的差异均无统计学意义。结论化疗联合腹腔循环热灌注治疗能明显提高恶性腹水患者近期疗效,改善生活质量,毒副作用小,受限于纳入研究数量和质量,上述结论有待更多高质量大样本长期随访的研究予以验证。

关键词: 恶性腹水, 化疗, 腹腔循环热灌注, Meta分析

Abstract: Objective To evaluate the clinical efficacy and safety of celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites.Methods Databases including the Cochrane Library MEDLINE,PubMed,Embase,CBM,VIP,CNKI and WanFang Data,and the other sources as supplying.The literatures were screened according to the inclusion criteria,extracted data and assessed the methodological quality,and then meta-analysis was performed using RevMan 5.0.2 software.Results Totally 14 RCTs with 867 patients were included.Meta-analysis showed that compared intraperitoneal chemotherapy,with celiac continued circulatory hyperthermia perfusion had a significant difference in CR(OR=3.18,95%CI:2.18~4.64,P＜0.00001),PR(OR=2.05,95%CI:1.51~2.77,P＜0.00001),overall effective rate(OR=4.88,95%CI:3.59~6.46,P＜0.00001).The incidence of adverse reactions was no statistically significant in the two groups.Conclusion Celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites demonstrates better efficacy and safety,but it still needs to verify the above conclusion.

Key words: Malignant ascites, Chemotherapy, Celiac continued circulatory hyperthermia perfusion, Meta-analysis

中图分类号:

R730.58

闫向勇,燕忠生,刘文超,丁辉. 化疗联合腹腔循环热灌注治疗恶性腹水疗效和安全性的Meta分析[J]. 实用肿瘤学杂志, 2016, 30(4): 356-364.

YAN Xiangyong ,YAN Zhongsheng ,LIU Wenchao ,DING Hui. Effect and safety of celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites Meta-analysis[J]. PRACTICAL ONCOLOGY JOURNAL, 2016, 30(4): 356-364.

参考文献

1 Woopen H,Sehouli J.Current and future options in the treatment of malignant ascites in ovarian cancer[J].Anticancer Res,2009,29(8):3353-3359.
2 Ba MC,Cui SZ,Lin SQ,et al.Chemotherapy with laparoscope-assisted continuous circulatory hyperthermic intraperitoneal perfusion for malignant ascites[J].World J Gastroenterol,2010,16(15):1901-1907.
3 Di Giorgio A,Naticchioni E,Biacchi D,et al.Cytoreductive surgery(peritonectomy procedures)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)in the treatment of diffuse peritoneal carcinomatosis from ovarian cancer[J].Cancer,2008,113(2):315-325.
4 Gesson-Paute A,Ferron G,Thomas F,et al.Pharmacokinetics of oxaliplatin during open versus laparoscopically assisted heated intraoperative intraperitoneal chemotherapy(HIPEC):an experimental study[J].Ann Surg Oncol,2008,15(1):339-344.
5 杨纪华,闵婕,李伟民,等.循环热灌注化疗治疗恶性腹腔积液疗效观察[J].现代肿瘤医学,2009,17(11):2185-2187.
6 胡宗兰,曹军丽,顾涛,等.腹腔热灌注联合全身化疗在卵巢癌恶性腹腔积液控制中的近期疗效[J].山东医药,2009,49(40):42-43.
7 蒋冬梅,闫明亮,张海亮,等.腹腔持续循环热灌注化疗治疗癌性腹腔积液的临床研究[J].陕西医学杂志,2010,39(1):42-44.
8 陈非,郭黔,罗舒,等.腹腔热灌注联合全身化疗治疗恶性腹腔积液的疗效观察[J].重庆医学,2011,40(34):3465-3466.
9 廖国清,曲怡梅,王红梅,等.循环热灌注化疗治疗晚期胃癌合并腹腔积液的临床研究[J].中国肿瘤临床,2012,39(8):452-454.
10 吴铁鹰,张峻青,刘永兰,等.腹腔循环热灌注化疗治疗恶性腹腔积液疗效观察[J].肿瘤研究与临床,2013,7(9):202-203.
11 李维,王华庆,赵阔,等.奈达铂腹腔热灌注化疗治疗癌性腹腔积液的疗效观察及分析[J].中国肿瘤临床,2012,39(22):1741-1744.
12 李娜,薄常文,邹长鹏,等.循环热灌注化疗与单纯灌注化疗治疗胃肠道肿瘤恶性腹腔积液的疗效比较[J].世界华人消化杂志,2013,21(33):3757-3761.
13 张立新,孙芳初,孙国贵,等.顺铂联合腹腔持续热灌注治疗胃癌腹腔转移癌性腹水的临床研究[J].中国肿瘤,2013,22(5):413-416.
14 王红梅,廖国清,邵艳,等.替吉奥联合顺铂腹腔热灌注化疗治疗晚期结直肠癌合并腹腔积液48例疗效观察[J].贵州医药,2014,22(27):23-24.
15 孙玉芬.腹腔热灌注联合全身化疗治疗卵巢癌恶性腹腔积液的近期疗效[J].中国肿瘤临床与康复,2013,20(4):369-370.
16 覃振赫.腹腔恒温循环热灌注化疗治疗癌性腹水的疗效[J].华夏医学,2013,26(3):504-506.
17 李涛,吴祥成,吴非常,等.多西他赛联合腹腔热灌注顺铂治疗卵巢癌腹腔积液18例[J].社区医学杂志,2013,11(11):47-48.
18 彭定宏,袁静,曹付梅.腹腔循环热灌注联合静脉化疗在胃癌合并腹腔积液的应用[J].中国实用医药,2014,9(7):166-167.
19 Fujimoto S,Shrestha RD,Kokubun M,et al.Intraperitoneal hypertheric perfusion combined with surgery effective for gastric cancer patients with peritoneal seeding[J].Ann Surg,1988,208(1):36-41.
20 Qian J,Truebenbach J,Graeple F,et al.Application of polylactide-co-glycolide -microspheres in the transarterial chemoembolization in an animal model of HCC[J].World J Gastroenterol,2003,9(1):94-98.

[1]	冯越,邢丽楠,王棹,张云艳. NLR与肿瘤同步放化疗预后的相关性研究[J]. 实用肿瘤学杂志, 2019, 33(3): 284-288.
[2]	梁虹, 李奇, 王耀先, 靳红, 王铜, 王亚楠, 段雅妮, 宋敏. 宫颈癌化疗心血管毒性预防的间断时间序列试验[J]. 实用肿瘤学杂志, 2019, 33(2): 134-138.
[3]	马志杰, 王帆, 赵亚双. 乳腺癌化疗患者生存质量及影响因素分析[J]. 实用肿瘤学杂志, 2019, 33(2): 149-154.
[4]	秦岚群, 邹征云. 恶性黑色素瘤化疗研究进展[J]. 实用肿瘤学杂志, 2019, 33(2): 167-172.
[5]	常晓霞综述, 宋冰冰, 刘家仁审校. 植物化学物增加肿瘤细胞对化疗药物敏感性的研究进展[J]. 实用肿瘤学杂志, 2019, 33(1): 67-72.
[6]	王亚龙, 吕章艳, 张帆, 冯小双, 魏锣沛, 李鑫, 温艳, 高禹舜, 薛奇, 高树庚, 谭锋维. 人乳头状瘤病毒感染与肺癌预后相关性的Meta分析[J]. 实用肿瘤学杂志, 2018, 32(6): 520-526.
[7]	姜亮亮综述, 王晶审校. 上皮性卵巢癌远处转移的诊治进展[J]. 实用肿瘤学杂志, 2018, 32(5): 480-482.
[8]	张婷, 贾迪(综述), 杨丹(审校). 骨肉瘤的生物学治疗进展[J]. 实用肿瘤学杂志, 2018, 32(3): 254-257.
[9]	翟可可, 高媛媛, 冯晓, 许静文, 宫玉芳, 孟庆威. 术后辅助化疗后复发转移与初次诊断的IV期NSCLC一线化疗疗效分析[J]. 实用肿瘤学杂志, 2018, 32(2): 107-111.
[10]	杨文娟, 余静, 黄朝, 张俊红, 谢丛华. 化疗早期重度粒细胞下降与小细胞肺癌预后相关性分析[J]. 实用肿瘤学杂志, 2018, 32(1): 19-24.
[11]	黎玉娇, 尚乃舰. 影像学评估乳腺癌新辅助化疗反应的研究进展[J]. 实用肿瘤学杂志, 2018, 32(1): 63-67.
[12]	梁语丝, 谭永刚, 邹华伟审校. 低剂量化疗作用机制的研究进展[J]. 实用肿瘤学杂志, 2017, 31(6): 538-542.
[13]	石峰,于雁. 节拍化疗通过影响血管形成及免疫系统抑制肿瘤细胞生长的机制[J]. 实用肿瘤学杂志, 2017, 31(4): 316-320.
[14]	董峰, 马君俊, 蔡正昊, 赵轩, 郑民华. 血清miR-21和miR-34a与晚期胃癌患者Folfox化疗方案化疗疗效的关系研究[J]. 实用肿瘤学杂志, 2017, 31(2): 147-151.
[15]	陈力, 张玉新, 左艳娇, 马菲, 宋洪江, 薛英威. SOX和XELOX在进展期胃癌新辅助化疗中的临床疗效比较[J]. 实用肿瘤学杂志, 2017, 31(1): 23-30.

化疗联合腹腔循环热灌注治疗恶性腹水疗效和安全性的Meta分析

Effect and safety of celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites Meta-analysis

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价