Objective To systematically review the effectiveness and safety of hyperthermia (HT) plus intraperitoneal hyperthermic perfusion chemotherapy (IHPC) versus IHPC alone for malignant ascites. Methods Such databases as PubMed, The Cochrane Library, EMbase, VIP, WanFang, CNKI and CBM were electronically and comprehensively searched for randomized controlled trials (RCTs) on HT plus IHPC vs. IHPC alone for malignant ascites from inception to March 2013. Two reviewers independently screened studies according to inclusion and exclusion criteria, extracted data and assessed quality of the included studies. References of the included studies were also retrieved. Then, meta-analysis was performed using RevMan 5.1 software. Results A total of 16 RCTs involving 984 patients were included. The results of meta-analysis showed that, compared with the IHPC alone group, the HT plus IHPC group had a higher effective rate of controlling ascites (OR=3.40, 95%CI 2.58 to 4.48, Plt;0.000 01), better improvement in quality of life (OR=2.77, 95%CI 1.90 to 4.05, Plt;0.000 01), with significant differences. The two groups were alike in 1-year survival with no significant difference (OR=1.80, 95%CI 0.61 to 5.31, P=0.28). As for safety, there was no significant difference between the two groups in the incidences of nausea and vomiting, abdominal distension and pain, myelosuppression, diarrhea, and constipation. Conclusion The results of this systematic review show that, compared with IHPC alone, HT plus IHPC improves the effective rate as well as the quality of life of patients with malignant ascites, and it does not increase the incidences of adverse reactions. Due to the limited quality and quantity of the included studies, more high quality RCTs with larger sample size are needed to verify the above conclusion.
目的:水泡口炎病毒(Vesicular Stomatitis Virus,VSV)基质蛋白(Matrix protein, M 蛋白)具有诱导肿瘤细胞凋亡的作用,本研究探讨水泡口炎病毒基质蛋白对癌性腹水形成的抑制和治疗作用。方法:采用旋转蒸发仪法制备纳米脂质体,检测其体外转染效率;采用脂质体转染技术将已构建的水泡口炎病毒基质蛋白(VSVM)重组真核表达质粒pcDNA31M 转入MethA肿瘤细胞,转染后6小时将细胞接种于小鼠腹腔,观察小鼠腹水的形成情况;腹水治疗组,则先将MethA肿瘤细胞接种于小鼠腹腔,将小鼠随机分成4组,于接种后第二天分别用脂质体包裹的pcDNA31M、pcDNA31空载体、单纯脂质体及生理盐水治疗,观察腹水的形成情况。结果:自制的DOTAP:DOPE脂质体与Sigma公司购买的Lipofectamine 2000的转染效率相似,pcDNA31M明显抑制MethA腹水的形成,对已经形成的腹水也有明显的治疗作用,与对照组比较有统计学意义(Plt;005),同时明显延长了小鼠的存活期。结论: VSVM蛋白真核表达质粒pcDNA31M对小鼠腹水的形成有抑制作用,能延长小鼠的存活期,对于恶性腹水的治疗具有一定的意义,值得进一步研究。