Meta-analysis Of Intraperitoneal Chemotherapy With Raltitrexed In Colorectal Cancer

Objective:In this study,the meta-analysis method was used to analyze the literature on intraoperative peritoneal malignant tumors treated with intraoperative intraperitoneal chemotherapy with raltitrexed in the past 10 years,and comprehensively evaluate the safety of raltitrexate in the treatment of colorectal cancer.Methods:Before March 2019,all the literatures about intraperitoneal infusion chemotherapy of Retitraxel for colorectal cancer were retrieved and analyzed,which were published in PubMed,Embase and Cochrane three English databases,as well as Chinese databases such as CNKI,Wanfang Data Knowledge Service Platform and SinoMed.Intraoperative intraperitoneal infusion chemotherapy of remittetraxel and non-remittetraxel infusion chemotherapy were compared.The incidence of adverse reactions and complications of intraperitoneal infusion chemotherapy in the treatment of colorectal cancer was assessed to evaluate the safety of intraperitoneal infusion chemotherapy with raltitrexate.The literature was screened strictly,the quality of literature was evaluated,and the effective data were extracted.At last,RevMan 5.3software was used to make meta-analysis of the time needed for the recovery of intestinal function and abdominal distension,diarrhea,nausea and vomiting,intestinal obstruction,incision infection,anastomotic leakage.Results:1.Including the basic situation of the literature: 10 articles were finally included.A total of 888 patients were enrolled,440 in the experimental group and 448 in the control group.There was no significant difference in gender and age between the two groups(P > 0.05).2.Comparing the occurrence of intestinal obstruction after operation between the two groups: The results showed that there was no significant difference in abdominal distension between the two groups,and that the incidence of intestinal obstruction after operation was not increased by Retitraxel.(OR = 1.35,95% CI:0.61-3.00,P > 0.05)3.Comparing the occurrence of nausea and vomiting after operation between the two groups: The results showed that there was no significant difference in the occurrence of nausea and vomiting after operation between the two groups,and that the occurrence of nausea and vomiting after operation was not significantly increased by Retitraxel.(OR = 1.68,95% CI: 0.70-4.05,P = 0.05).4.Comparisons of diarrhea after operation between the two groups: The results showed that there was no significant difference in the occurrence of diarrhea after operation between the two groups.Retitraxel did not significantly increase the occurrence of diarrhea after operation(OR = 1.64,95% CI: 0.85-3.15,).5.Comparing the abdominal distension after operation between the two groups: The results showed that there was no significant difference between the two groups.Retitraxel did not increase the risk of abdominal distension after operation(OR=1.23,95% CI:0.35~4.29,P>0.05).6.Comparing the incidence of incision infection after operation between the two groups: The results showed that there was no significant difference in incision infection between the two groups.Retitraxel did not increase the incidence of incision infection after operation(OR = 0.83,95% CI: 0.49-1.42,P > 0.05).7.Comparing the occurrence of anastomotic fistula after operation between the two groups: The results showed that there was no statistical difference in the occurrence of anastomotic fistula between the two groups.Retitraxed did not increase the risk of anastomotic fistula after operation(OR = 2.00,95% CI: 0.70-5.68,P >0.05).8.Comparing the recovery of intestinal function after operation between the two groups: The results showed that there was no significant difference in therecovery time of intestinal function between the two groups.Retitraxel did not prolong the recovery time of intestinal function after operation(WMD=-0.04,95%CI:-0.11-0.03,P > 0.05).Conclusions:1.The adverse reactions(abdominal distension,diarrhea,nausea and vomiting)and complications(intestinal obstruction,incision infection,anastomotic leakage)of the patients in the intraperitoneal infusion chemotherapy group were not significantly increased.2.The recovery time of intestinal function was not significantly increased in the Retitraxel group compared with the non-Retitraxel group.In summary,from the point of view of this study,intraoperative intraperitoneal infusion of Retitraxel is safe and does not increase the risk of postoperative adverse reactions and complications.However,this study still has limitations,and its efficacy still needs further multi-center,large sample,high-quality clinical control study to provide theoretical basis.