| Objective: To compare the clinical value of intraperitoneal chemotherapy(IPC) and intravenous chemotherapy(IVC) for ovarian carcinoma systematically so as to provide decision-making evidence for clinical application.Methods: MEDLINE (1978-2004), PUBMED(1966-2004) and EMBASE(1989-2004) searches were supplemented by information from trails registers. Searches were limited on publications in English, concerning RCT(randomized clinical trail) for IPC and IVC of late stage ovarian carcinoma after surgery. All included studies of RCT were published in English comparing effect of IPC with IVC( first-line chemotherapy) or with No Treatment(NT) (consolidation chemotherapy) for ovarian carcinoma, and providing the ratio of overall survival or proceeding-free survival. Quality evaluation of methodologies of all included studies was done by two reviewers independently according to Jadad standard. The ratios of 2-year progress-free survival, 5-year progress-free survival , 2-year overall survival , 5-year overall survivaland the ratio of the side-effects were collected and analyzed with the software of Review Manager (RevMan4.2), downloaded from www.cochrane. org.Results: 1>In the treatment of late stage ovarian carcinoma , IPC as first-line chemotherapy compared with IVC could obviously improve the ratio of 2-year PFS and 2-year OS, and the difference has statistical significance, while it has little effect on long term PFS and OS. 2>As consolidation chemotherapy compared with IVC, IPC could improve the ratio of 2-year and 5-year OS, which is statistical significance. 3> The influence of IPC to the side-effects of the drugs is various. Conclusion: IPC could improve the short-term progress-free survival and postpone the recrudesce of carcinoma of the patients in late stage ovarian carcinoma, but its effect on long-term survival is not sure, and large sample RCTs including life quality evaluation are necessary. The influence of IPC to the side-effects of the drugs is various. |
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