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.
Objective To evaluate the effectiveness and safety of postoperative intraperitoneal hyperthermic perfusion chemotherapy (IHPC) for advanced gastric cancer, so as to provide references for clinical practice and study. Methods The following databases including The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and WanFang were searched on computer, and other searches were also performed to collect all relevant randomized controlled trials (RCTs) on postoperative IHPC versus intravenous chemotherapy alone (IC) for advanced gastric cancer. The quality of the included studies was assessed according to Cochrane Handbook 5.1 for Systematic Review, and Meta-analysis was conducted by using RevMan 5.1 software. Results A total of 18 RCTs involving 2299 patients were included. The results of meta-analyses showed that: a) Efficacy evaluation: There were significant differences between the IHPC group and the IC group in 1-, 2-, 3-, and 5-year survival rate, 3- and 5-year recurrence rate, and 3- and 5-year distant metastasis rate; the OR value and 95%CI were 1.88 (1.49, 2.39), 2.45 (1.64, 3.67), 2.29 (1.92, 2.73), 2.17 (1.70, 2.76), 0.39 (0.29, 0.52), 0.54 (0.40, 0.72), 0.55 (0.38, 0.78), 0.58 (0.42, 0.81), respectively; b) Safety evaluation: There were significant differences between the IHPC group and the IC group in the incidence of abdominal pain, abdominal distension, nausea and vomiting; the OR value and 95%CI were 2.20 (1.58, 3.07), 7.00 (2.67, 18.36), 0.65 (0.45, 0.95), respectively. But there were no significant differences between the IHPC group and the IC group in the incidence of alopecia, ileus, bone marrow inhibition, and hepatic lesion. Conclusion Compared with IC, postoperative IHPC+IC can improve survival rate and reduce the recurrence and distant metastasis rate; additionally, it is safe and feasible, so it is recommended that the detailed condition of patients should be taken into consideration when the postoperative IHPC+IC therapy is applied to clinic.
ObjectiveTo systematically review the effectiveness and safety of intraperitoneal hyperthermic perfusion chemotherapy (IHPC) for ovarian cancer, so as to provide references for clinical practice and studies. MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 6, 2013), Web of Science, WanFang Data, CBM, VIP and CNKI for randomized controlled trials (RCTs) about IHPC vs. intravenous chemotherapy (IC) for ovarian cancer from the inception of the databases to June 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Then meta-analysis was performed using RevMan 5.1 software. ResultsA total of 10 RCTs involving 723 patients were included. The results of meta-analysis showed that the IHPC group was superior to the IC group in clinical efficiency (OR=4.02, 95%CI 2.85 to 5.68, P < 0.000 01), clinical benefit response (OR=3.41, 95%CI 2.13 to 5.45, P < 0.000 01), recurrence and metastasis rates (OR=0.29, 95%CI 0.20 to 0.42, P < 0.000 1), and overall survival rates (OR=3.30, 95%CI 1.82 to 5.99, P < 0.000 1). In the aspect of safety, no significant difference was found in bone marrow suppression, hemoglobin reduction, nausea and vomiting between two groups. ConclusionIHPC for ovarian cancer can improve clinical efficiency, clinical benefit response and overall survival rates, and reduce recurrence and metastasis rates; and it is also safe for patients.