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《Journal of Practical Oncology》 2012-06
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Intraperitoneal hyperthermic perfusion chemotherapy for resectable advanced gastric cancer:a Meta-analysis

LI Zheng1,2,MI Deng-hai1,2,3,YANG Ke-hu1,2,et al(1.Evidence Based Medicine Center of Lanzhou University,Lanzhou,730000,China; 2.The First College of Clinical Medicine,Lanzhou University,Lanzhou,730000,China; 3.Department of Oncology,the Second People′s Hospital of Gansu Province,Lanzhou,730000,China)  
Objective To evaluate the efficacy and safety of intraoperative combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy(IHPC) for the treatment of advanced gastric cancer.Methods The databases of Cochrane Library,PubMed,EMBASE,CBM,CNKI,VIP,Wanfang and other sources were searched,and communication with other authors were also made.All relevant randomized controlled trials(RCTs) were collected to compare intraoperative plus postoperative IHPC with routine intravenous chemotherapy(IC)alone for advanced gastric cancer.The quality of the included studies was assessed by adequate standard.Meta-analysis was conducted by RevMan 5.1 software.Results Thirteen RCTs involving 1 804 patients were included.The efficacy evaluation by Meta-analysis revealed that the 1,2,3,5-year survival rates of IHPC group were higher than those of IC group.The Meta-results of survival rates were,,and,respectively.The 1,3,5-year recurrence rate and 3,5-year distant metastasis rate of IHPC group were lower than those of IC group.The OR value and 95% CI were [0.38,(0.18,0.77)],[0.26,(0.18,0.37)],[0.30,(0.23,0.39)],[0.32,(0.15,0.68)] and [0.51,(0.32,0.81)],respectively.The safety evaluation revealed by Meta-analysis showed that there was significant difference between IHPC group and IC group in the incidence of abdominal pain,the OR value and 95% CI was [4.23,(2.14,8.35)],while there was no significant difference between IHPC group and IC group in the incidence of nausea and vomiting,bone marrow inhibition and hepatic lesion.Conclusion Compared with routine IC,intraoperative plus postoperative IHPC can improve survival rate and reduce recurrence rate and distant metastasis rate,besides its side effects are acceptable.More large-sample and high quality RCTs are needed to verify its long-term effect.
【Key Words】: stomach neoplasms/drug therapy hyperthermia induced antineoplastic combined chemotherapy protocols postoperative period infusions parenteral survival rate randomized controlled trial meta analysis
【Fund】: 甘肃省卫生行业科研计划项目(GSWST09-06);; 兰州大学循证医学中心循证医学研究生创新基金(2010LDEBM-A)
【CateGory Index】: R735.2
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