The Curative Effect And Safety Of Radical Resection Combined With Hyperthermic Intraperitoneal Chemotherapy In The Treatment Of Advanced Colorectal Cancer Meta Analysis

Objective: It is still controversial whether combined hyperthermic intraperitoneal chemo-therapy(HIPEC)can improve the prognosis of patients with advanced colorectal cancer compared with intravenous chemotherapy alone.The purpose of this study was to explo-re the effectiveness and safety of HIPEC combined with intravenous chemotherapy for patients with advanced colorectal cancer,and to provide clinical basis for clinical chemo-therapy.Methods: Through searching,Chinese Journal Full-text Database(CNKI),Pub Med,Cochrane Libary,Embase,Wanfang database and VIP database,we compared the patients with advanced colorectal cancer with postoperative venous chemotherapy and postoperative venous chemotherapy with hyperthermic intraperitoneal chemotherapyin meta-analysis.The search deadline is December 31,2017.Results:A total of 20 trials were included,with a total of 1730 patients from China.The results of meta-analysis showed that the curative effect of radical plus chemotherapy was significantly improved by 1 year,2 years and 3 years(OR = 2.59,95% CI: 1.96-3.42,P<0.00001)5-year overall survival rate compared with that after radical operation alone.,and with the extension of follow-up,radical surgery combined with chemotherapy group survival benefit more obvious.At the same time,the rate of tumor recurrence decreased in the combination chemotherapy group.The results showed that the recurrence rate after5 years was significantly decreased at 1 year and 3 years after operation(OR = 0.29,95%CI: 0.18-0.48,P <0.00001).The metastasis rate of the combined chemotherapy group was significantly lower than that of the control group after 1 year and 3 years(OR = 0.27,95% CI: 0.16-0.46,P <0.00001).The combination chemotherapy group is more effective(OR = 2.83,95% CI: 1.61-4.98,P = 0.0003),and the postoperative quality of life was better(OR = 3.58,95% CI: 1.91-6.69,P <0.0001).On this basis,the incidence of postoperative complications was not increased(OR = 0.98,95% CI: 0.68-1.41,P = 0.91),nor did it increase the incidence of adverse reactions to chemotherapy,including the incidence of severe adverse reactions(OR = 1.19,95% CI: 0.85-1.66,P = 0.32),incidence of digestive system adverse reactions(OR = 1.21,95% CI: 0.94-1.54,P = 0.14)1.21,95% CI: 0.94-1.56,P = 0.14)and the control group had no statistical significance.Conclusion: From our point of view,HIPEC combined with intravenous chemotherapy has a significant survival benefit for the patients with advanced colorectal cancer and has improved the quality of life.And it has not increased the operative complications and the adverse reactions of chemotherapy.It is effective and safe.But still need to be more centers and large sample clinical trials to prove.