| Objective: This study was to evaluate the clinical efficacy and safety of HIPEC,according to analyze the prognosis of 78 patients with advanced ovarian cancer who underwent hyperthermic intraperitoneal chemotherapy(HIPEC).To provide a basis for more effective application of HIPEC in clinical.Method:A retrospective analysis was made on the clinical data of 78 patients who had received hyperthermic intraperitoneal chemotherapy for stage III-IV newly-treated ovarian cancer from June 2017 to June 2019 and were treated by the Fourth Hospital of Hebei Medical University(HIPEC group).Compared with 41 patients who did not receive HIPEC(control group)during the same period.All patients underwent cytoreductive surgery plus intravenous chemotherapy.The observation indexes of ascites remission,CA125 changes at three months after operation,and progression-free survival were compared between the two groups,so that the clinical efficacy,recurrence and adverse reactions after treatment were evaluated.According to the modified Fagotti score before surgery,to decide to perform primary debulking surgery(PDS)(Fagotti <8 points),or neoadjuvant chemotherapy(NACT)+ interval debulking surgery(IDS)(Fagotti ? 8 points).Result:1.Changes in CA125 level: The effective response rate of the HIPEC group was 97.4%(76/78),which was higher than that of the control group,which was 85.4%(35/41)(P=0.02<0.05).2.Ascites remission degree: 98.3% in the HIPEC group(57/58),which was higher than 86.5% in the control group(32/37).The results of the two were statistically significant(P=0.032<0.05).3.Progression-free survival(PFS): The PFS in the HIPEC group was 30.17 months(95% CI 27.29-33.05),and the control group was 22.24 months(95% CI 18.25-26.22)(P=0.001<0.05).4.Adverse reactions and postoperative complications after chemotherapy: Mainly manifested in bone marrow suppression,abdominal distension and abdominal pain,intestinal obstruction.Four patients in the HIPEC group had grade III-IV bone marrow suppression,one patient had intestinal obstruction,and 18 patients had abdominal distension and abdominal pain,while the control group had 2,2,and 3,respectively.There was no significant difference in the incidence of bone marrow suppression and intestinal obstruction between the two groups(P>0.05).In terms of abdominal distension and abdominal pain,the incidence of the HIPEC group was significantly higher than that of the control group(23.1%vs7.3%,P=0.042<0.05).All can be relieved after treatment.5.Compare the PFS in the HIPEC group and the control group in patients aged ?65 years,27.29 months and 16.80 months,respectively(P= 0.011<0.05).In the HIPEC group,there was no significant difference in PFS between patients <65 years old and patients 65 years or older(29.71vs27.29 months,P=0.542>0.05)6.In the HIPEC group,there was no significant difference in PFS between NACT + IDS and PDS(24.14vs31.62 months,P=0.379>0.05).There were no significant differences in adverse reactions and postoperative complications(P>0.05).Regardless of the type of CRS,the PFS in the HIPEC group was better than that in the control group.7.In ovarian cancer,the PFS of non-serous cancer patients in the HIPCE group was better than that of the control group(21.66vs13.75 months P=0.019<0.05),and there was no difference compared with the PFS of serous cancer patients who received HIPEC(30.46vs21.66 months,P=0.571>0.05).Conculsion:1.Compared with intravenous chemotherapy alone,HIPEC combined with intravenous chemotherapy can effectively prolong the survival of patients without increasing the incidence of adverse reactions.2.Compared with intravenous chemotherapy alone,the addition of HIPEC can effectively control ascites and reduce the pain of patients with advanced ovarian cancer caused by ascites.3.Elderly ovarian cancer patients aged 65 years and older can also benefit from HIPEC without increasing the risk of adverse reactions.4.HIPEC after NACT + IDS or PDS has no difference in safety and treatment effect.It can prolong recurrence better than simple intravenous chemotherapy.For patients with advanced ovarian cancer tumor overload,NACT + IDS can replace PDS.5.Patients with non-serous ovarian cancer,like patients with serous ovarian cancer,can get better results with HIPEC than with intravenous chemotherapy alone. |
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