| Objective:This study compares the application of intraperitoneal thermal perfusion chemotherapy after ovarian cancer surgery with conventional intravenous chemotherapy after ovarian cancer surgery in advanced ovarian cancer.By comprehensively comparing the clinical efficacy,tumor marker levels,ascites control rate,survival rate,and safety of the two,the application value of intraperitoneal thermal perfusion chemotherapy in advanced ovarian cancer is systematically evaluated.Methods:Using a computer to search PubMed,Cochrane library,Embase,CNKI,Wanfang,VIP,Chinese Biomedical Literature Data(CBM)and other databases,all randomized controlled trials and case-control studies related to intraperitoneal hyperthermic perfusion chemotherapy after ovarian cancer surgery were conducted from the establishment of each database until March 2022.Extract various indicators required,and use Rev Man5.3 and R Studio for meta-analysis of all data.Results:A total of 23 articles were included,including 9 randomized controlled trials and 14 retrospective studies.A total of 2269 patients were included,including 1075 cases in the tumor cell reduction surgery combined with intraperitoneal thermal perfusion chemotherapy group(referred to as the H group);There were 1191 cases in the non H group treated with tumor cell reduction surgery without intraperitoneal hyperthermia perfusion chemotherapy.The meta-analysis results showed that:(1)in terms of survival rate,the final result was statistically significant,indicating that the addition of HIPEC prolonged the 1-year survival rate(OR and its 95% confidence interval were 2.6641 [1.5201;4.6691],P value<0.001)and5-year survival rate(OR and its 95% confidence interval were 1.7989 [1.2365;2.6171],P value<0.001);(2)In terms of incidence of adverse reactions: Compared with the two groups,in terms of gastrointestinal adverse reactions(OR and 95% confidence interval 0.7486[0.5086;1.1017],P value greater than 0.05),bone marrow suppression(OR and 95%confidence interval 1.0233 [0.5863;1.7860],P value greater than 0.05),liver function damage(OR and 95% confidence interval 1.0233 [0.5863;1.7860],P value greater than 0.001),There was no statistically significant difference in renal function impairment(OR and its 95%confidence interval were 0.9229 [0.4729;1.8011],with a P value greater than 0.05),indicating that HIPEC does not bring excessive chemotherapy side effects to patients and its safety is reliable;(3)The control rate of ascites: The difference between the two groups was statistically significant,indicating that HIPEC can improve the control rate of ascites and inhibit the recurrence rate of patients(OR and its 95% confidence interval were 4.9804[2.8720;8.6368],with a P value less than 0.001);(4)In terms of clinical efficacy: Compared with the two groups,the difference is statistically significant,indicating that HIPEC has higher clinical efficacy and efficiency,more effective in alleviating clinical symptoms,and improving the quality of life of patients;(5)In terms of CA125 levels,the difference between the two groups was statistically significant,indicating that HIPEC can better and more effectively reduce the serum CA125 levels of patients and reduce the recurrence rate;(6)In terms of overall survival and progression free survival,the difference between the two groups was statistically significant,indicating that HIPEC can prolong the overall survival and progression free survival of patients,and prolong their lifespan.Conclusions:1.Whether it is primary or recurrent ovarian cancer patients,adding intraperitoneal hyperthermic perfusion chemotherapy after ovarian cancer surgery can prolong the overall survival and progression free survival of patients,improve 1-year and 5-year survival rates,improve the control rate of ascites and clinical efficacy,more effectively reduce the patient’s serum CA125 level,and reduce recurrence rate.2.Adding intraperitoneal thermal perfusion chemotherapy after ovarian cancer surgery does not increase the incidence of adverse reactions and has a lower risk.3.The number of literature included in this article is limited,and there are differences in the chemotherapy regimen,infusion medication,and infusion timing of hyperthermia perfusion,as well as statistical research outcome methods.The conclusions drawn still need more cutting-edge,multicenter,and large sample research data to verify. |
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