Efficacy And Safety Of Hyperthermia Combined With Chemotherapy In The Treatment Of Advanced Ovarian Cancer

Background and purposeOvarian cancer is one of the most common malignant tumors in the female reproductive system,its incidence is only to cervical cancer and uterine cancer,ranking third,but the mortality ranks first.According to statistics in 2018,the number of new cases of ovarian cancer in the world is about 300000.It is equivalent to 3.4%of all female malignant tumors,and its fatality rate is 4.4%.There are 22530 new cases of ovarian cancer and 13980 deaths in the United States each year.In China,the incidence of ovarian cancer in urban women is 12.7/100000 years,and that in rural women is 8.2/100000 years,which undoubtedly brings a heavy burden to the health and economic development of human society.The anatomical position of the ovary is special and belongs to intraperitoneal organs.The symptoms of the early lesions are not obvious,and about 70%of the patients with ovarian cancer are in the late clinical stage,accompanied by the wide spread of the peritoneal cavity.At present,chemotherapy is the common treatment for advanced ovarian cancer,but it is easy to produce drug resistance.The 5-year survival rate of patients with ovarian cancer is far lower than that of other malignant tumors,which is only 29%.Therefore,it is urgent to explore new anti-tumor strategies.Hyperthermia is the fifth most common treatment of cancer after surgery,radiotherapy,chemotherapy and immunotherapy,which means that when used alone or in combination with other treatments(such as radiotherapy,chemotherapy,etc.),using exogenous heat to heat the local tumor tissue to 40?43 ? can directly or indirectly kill tumor cells.By denaturing unstable repair proteins such as DNA polymerase and inhibiting DNA repair,hyperthermia has a significant synergistic effect with DNA damage agents to enhance the efficacy of chemotherapeutic drugs,such as cisplatin,cyclophosphamide,temozolomide and so on.Hyperthermia can significantly inhibit the expression of multidrug resistance(multidrug resistance,MDR)gene in tumor cells and improve the effective rate of chemotherapeutic drugs.This study retrospectively analyzed and summarized the clinicopathological data of patients with advanced ovarian cancer,and followed up the patients,in order to explore the efficacy and safety of hyperthermia combined with cisplatin/paclitaxel chemotherapy in the treatment of patients with advanced ovarian cancer.Meterials and MethodsPatients with advanced ovarian cancer treated in the first affiliated Hospital of Zhengzhou University from June 2016 to May 2019 were collected.According to whether hyperthermia was included or not,44 patients in the control group were treated with simple chemotherapy(cisplatin/paclitaxel),and 41 patients in the observation group were treated with hyperthermia combined with chemotherapy.the curative effect was evaluated every 2 cycles for a total of 6 cycles until the disease progressed or died,and the efficacy and safety were observed.Results1.Clinical efficacy:The objective response rate and disease control rate in the observation group were 46.3%and 78.0%,respectively,while those in the control group were 25.0%and 56.8%(P<0.05).The median progression-free survival time was 13.2 months(95%CI:9.6?16.8)in the observation group and 9.6 months(95%CI:7.5?11.2)in the control group.2.Cox univariate analysis:ECOG score,abnormal serum tumor markers and distant metastasis were related to the prognosis of patients.Patients with ECOG score of 0?1,normal serum tumor markers and no distant metastasis had a better prognosis.Age,pathological type,mode of chemotherapy and previous operation had nothing to do with the prognosis.3.Cox multivariate analysis:whether the serum tumor markers are normal or not is an independent influencing factor.4.Adverse reactions:The main adverse reactions of the two groups were digestive tract reaction,hematology,nerve injury,fatigue,fat induration and injury of liver and kidney function.The incidence of nausea,vomiting and fatigue in the control group was significantly higher than that in the observation group(P<0.05).Conclusion1.The short-term efficacy and progression-free survival time of patients with advanced ovarian cancer treated by hyperthermia combined with chemotherapy were better than those in the control group.2.ECOG score,abnormality of serum tumor markers and distant metastasis are related to the prognosis of patients,among which whether the serum tumor markers are normal or not is an independent influencing factor.Patients with ECOG score of 0?1,normal serum tumor markers and no distant metastasis had a better prognosis.3.Hyperthermia combined with cisplatin/paclitaxel has good tolerance and mild adverse reactions,which can be popularized in clinic.