Chemotherapy Combined with Hyperthermia for Advanced Colorectal Cancer: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

XIE Baoping ^1,2 , LI Zheng ^1,2 ,  YAO Nan ¹ , HE Zhiyu ²

1. Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China;2. The First Clinical Medicine College of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

YAO Nan, Email: yaonan1122@sina.com

Keywords：

Colorectal neoplasms; Colonic neoplasms; Rectal neoplasms; Chemotherapy; Hyperthermia; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20130060

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the effectiveness and safety of hyperthermia combined with chemotherapy for advanced colorectal cancer.
Methods 　Databases such as CNKI, VIP, WanFang Data, CBM, EMbase, PubMed and The Cochrane Library (Issue 3, 2012) were electronically searched from the date of their establishment to June, 2012, and the relevant literature and conference proceedings were also manually searched to include randomized controlled trials (RCTs) on comparison of chemotherapy with hyperthermia plus chemotherapy for advanced colorectal cancer. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then the meta-analysis was performed by using RevMan 5.1 software.
Results 　A total of 11 RCTs involving 708 patients with advanced colorectal cancer were included. The results of meta-analysis showed that: a) as for effectiveness, the chemotherapy combined with hyperthermia group was superior to the chemotherapy group in the partial improve rate (OR=1.65, 95%CI 1.39 to 1.97, P lt;0.000 01) and the total effective rate (OR=3.59, 95%CI 2.51 to 5.12, P lt;0.000 01), with significant differences; b) as for safety, the chemotherapy combined with hyperthermia group was lower than the chemotherapy group in the incidence of neurotoxicity (OR=0.50, 95%CI 0.33 to 0.75, P=0.000 8).
Conclusion 　Compared with chemotherapy, chemotherapy combined with hyperthermia can increase partial improve rate and total effective rate and reduce the incidence of neurotoxicity. Due to the limitation of the included studies, large sample size, multicenter, high quality studies are needed to verify the above conclusion. We recommend that chemotherapy combined with hyperthermia therapy could be applied to clinic combining individual conditions of patients.

Citation： XIE Baoping,LI Zheng,YAO Nan,HE Zhiyu. Chemotherapy Combined with Hyperthermia for Advanced Colorectal Cancer: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(3): 352-357. doi: 10.7507/1672-2531.20130060 Copy

1.	Jemal A, Siegel R, Ward E, et al. Cancer statistics. CA Cancer J Cli, 2007, 58(2): 71-96.
2.	Tournigand C, Andre T, Achille E, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol, 2004, 22(2): 229-237.
3.	顾晋. 直肠癌多学科综合治疗模式与实践. 中华外科杂志, 2010, 48(21): 1607-1609.
4.	Jones EL, Oleson JR, Prosnitz LR, et al. Randomized trial of hyperthermia and radiation for superficial tumors. J Clin Oncol, 2005, 23(13): 3079-3085.
5.	李彩云, 郑英, 杨仁荣. 热疗联合化疗对人胃癌活体细胞的抑制作用研究. 临床军医杂志, 2006, 34(5): 541-544.
6.	Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst, 2000, 92(3): 205-216.
7.	World Health Organization. WHO Handbook for Reporting Results of Cancer Treatment Offset Publication No.48. Geneva. WHO press,1979.
8.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011[OL]. Available from: www.Cochrane-handbook.org.
9.	Review Manager (RevMan) [Computer program]. Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
10.	阳月新, 付挺. 卡培他滨和伊利替康联合热疗治疗晚期结直肠癌疗效观察. 医学临床研究, 2009, 26(3): 432-434.
11.	吴学勇, 谢芳, 张正华, 等. 热疗同CapeOx化疗治疗晚期结直肠癌临床研究. 中国癌症杂志, 2009, 19(3): 201-205.
12.	胡章华, 彭杰. 热疗联合folfiri化疗治疗晚期结直肠癌的临床观察. 肿瘤预防与治疗, 2010, 23(4): 301-304.
13.	曹红敏, 董勇, 孙一. XELOX方案联合热疗对结肠癌肝转移的临床研究. 中国中医药咨讯, 2010, 2(14): 130.
14.	王远东, 徐岗, 周明. 全身热疗联合奥沙利铂方案治疗晚期结直肠癌. 中国肿瘤, 2005, 14(1): 66-68.
15.	许凤, 陈石伟, 李勇, 等. 介入、热疗联合FOLFOX辅助治疗术后Ⅲ期结肠癌患者的疗效分析. 中国癌症杂志, 2011, 21(1): 52-55.
16.	阮新建, 刘畅, 刘兵, 等. 化疗联合射频热疗治疗晚期大肠癌的临床观察. 实用癌症杂志, 2011, 26(2): 178-180.
17.	刘庆春, 刘德传, 黄琼, 等. Folfox6方案联合腹部内生场热疗治疗晚期大肠癌的临床研究. 临床肿瘤学杂志, 2011, 16(2): 158-161.
18.	徐旭东, 高雪梅, 杨仁荣, 等. 区域亚高温联合奥沙利铂方案治疗晚期直肠癌. 实用肿瘤杂志, 2006, 21(5): 446-448.
19.	吕伽林, 刘海鹰, 鲁伟群, 等. 全身热疗联合FOLFOX7方案治疗晚期大肠癌近期疗效观察. 中华物理医学与康复杂志, 2006, 28(6): 412-414.
20.	唐又群, 曹培国, 潘宇亮, 等. 热疗联合奥沙利铂与5-Fu/CF治疗晚期结直肠癌. 医学临床研究, 2006, 23(9): 1420-1422.
21.	Hidebrandt B, Wust P, Ahlers O, et al. The cellular and molecular basis of hyperthermia. Crit Rev Oncol Hematol, 2002, 43(1): 33-56.
22.	Sawaji Y, Sato T, Seiki M, et al. Heat shock-mediated transient increase in intracellular 3’5’-cyclic AMP results in tumor specific suppression of membrane tyoe 1-matrix metalloprote inase production and progelatinaseA activation. Clin Exp Metasis, 2000, 18(2): 131-138.
23.	李征, 杨克虎, 米登海, 等. 进展期胃癌术后腹腔热灌注化疗有效性和安全性的系统评价. 中国循证医学杂志, 2011, 11(12): 1402-1408.
24.	李征, 米登海, 杨克虎, 等. 介入化疗栓塞术联合热疗治疗原发性肝癌的Meta分析. 中国循证医学杂志, 2012, 12(6): 672-678.
25.	米登海, 李征, 杨克虎, 等. 热放化三联疗法治疗非小细胞肺癌的Meta分析. 中国循证医学杂志, 2011, 11(11): 1262-1267.
26.	王道英, 李征, 杨克虎, 等. 放疗联合热疗治疗局部晚期非小细胞肺癌疗效与安全性的系统评价. 中国循证医学杂志, 2012, 12(10): 1203-1208.
27.	Wust P, Hidebrandt B, Streenivasa G, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol, 2002, 3(8): 489-497.
28.	Westermann AM, Wiedemann GJ, Jager E, et al. A Systemic Hyperthermia Oncologic Working Group trial. Ifosfamide, carboplatin, and etoposide combined with 41.8 degrees C whole-body hyperthermia for metastatic soft tissue sarcoma. Oncology, 2003, 64(4): 312-321.
29.	Yasuda M, Kondo M, Kokura S, et al. Comparison of concomitant gemcitabine chemotherapy and local hyperthermia, gemcitabine monochemotherapy, and local hyperthermia monotherapy for inoperable progressive pancreatic cancer. J Clin Oncol, 2008, 26(suppl): 15672.
30.	National Comprehensive Cancer Network (NCCN). Melanoma. NCCN Clinical Practice Guidelines in Oncology. Washington: PA: NCCN.
31.	Brozovic A, Simaga S, Osmak M. Induction of heat shock protein 70 in drug-resistant cells by anticancer drugs and hyperthermia. Neoplasma, 2001, 48(2): 99-103.
32.	徐中林. 恶性肿瘤的热切除治疗. 国外医学(肿瘤学分册), 2002, 29(4): 277.
33.	Arends J. Effects of a combined thermochemotherapy on markers of apoptosis, differentiation and adhesion in the human mammary carcinoma MX-1. A light microscopic and immunohistochemical study. Ann Anat, 2000, 182(4): 339-347.
34.	Walther W, Stein U, Schlag PM, et al. Use the human MDR1 promoter forheat-inducible expression of therapeutic genes. Int J Cancer, 2002, 98(2): 291-296.
35.	Yoo J, Kim HR, Lee YJ. Hyperthermia enhances tumour necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis in human cancer cells. Int J Hyperthermia, 2006, 22(8): 713-728.

1. Jemal A, Siegel R, Ward E, et al. Cancer statistics. CA Cancer J Cli, 2007, 58(2): 71-96.
2. Tournigand C, Andre T, Achille E, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol, 2004, 22(2): 229-237.
3. 顾晋. 直肠癌多学科综合治疗模式与实践. 中华外科杂志, 2010, 48(21): 1607-1609.
4. Jones EL, Oleson JR, Prosnitz LR, et al. Randomized trial of hyperthermia and radiation for superficial tumors. J Clin Oncol, 2005, 23(13): 3079-3085.
5. 李彩云, 郑英, 杨仁荣. 热疗联合化疗对人胃癌活体细胞的抑制作用研究. 临床军医杂志, 2006, 34(5): 541-544.
6. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst, 2000, 92(3): 205-216.
7. World Health Organization. WHO Handbook for Reporting Results of Cancer Treatment Offset Publication No.48. Geneva. WHO press,1979.
8. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011[OL]. Available from: www.Cochrane-handbook.org.
9. Review Manager (RevMan) [Computer program]. Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
10. 阳月新, 付挺. 卡培他滨和伊利替康联合热疗治疗晚期结直肠癌疗效观察. 医学临床研究, 2009, 26(3): 432-434.
11. 吴学勇, 谢芳, 张正华, 等. 热疗同CapeOx化疗治疗晚期结直肠癌临床研究. 中国癌症杂志, 2009, 19(3): 201-205.
12. 胡章华, 彭杰. 热疗联合folfiri化疗治疗晚期结直肠癌的临床观察. 肿瘤预防与治疗, 2010, 23(4): 301-304.
13. 曹红敏, 董勇, 孙一. XELOX方案联合热疗对结肠癌肝转移的临床研究. 中国中医药咨讯, 2010, 2(14): 130.
14. 王远东, 徐岗, 周明. 全身热疗联合奥沙利铂方案治疗晚期结直肠癌. 中国肿瘤, 2005, 14(1): 66-68.
15. 许凤, 陈石伟, 李勇, 等. 介入、热疗联合FOLFOX辅助治疗术后Ⅲ期结肠癌患者的疗效分析. 中国癌症杂志, 2011, 21(1): 52-55.
16. 阮新建, 刘畅, 刘兵, 等. 化疗联合射频热疗治疗晚期大肠癌的临床观察. 实用癌症杂志, 2011, 26(2): 178-180.
17. 刘庆春, 刘德传, 黄琼, 等. Folfox6方案联合腹部内生场热疗治疗晚期大肠癌的临床研究. 临床肿瘤学杂志, 2011, 16(2): 158-161.
18. 徐旭东, 高雪梅, 杨仁荣, 等. 区域亚高温联合奥沙利铂方案治疗晚期直肠癌. 实用肿瘤杂志, 2006, 21(5): 446-448.
19. 吕伽林, 刘海鹰, 鲁伟群, 等. 全身热疗联合FOLFOX7方案治疗晚期大肠癌近期疗效观察. 中华物理医学与康复杂志, 2006, 28(6): 412-414.
20. 唐又群, 曹培国, 潘宇亮, 等. 热疗联合奥沙利铂与5-Fu/CF治疗晚期结直肠癌. 医学临床研究, 2006, 23(9): 1420-1422.
21. Hidebrandt B, Wust P, Ahlers O, et al. The cellular and molecular basis of hyperthermia. Crit Rev Oncol Hematol, 2002, 43(1): 33-56.
22. Sawaji Y, Sato T, Seiki M, et al. Heat shock-mediated transient increase in intracellular 3’5’-cyclic AMP results in tumor specific suppression of membrane tyoe 1-matrix metalloprote inase production and progelatinaseA activation. Clin Exp Metasis, 2000, 18(2): 131-138.
23. 李征, 杨克虎, 米登海, 等. 进展期胃癌术后腹腔热灌注化疗有效性和安全性的系统评价. 中国循证医学杂志, 2011, 11(12): 1402-1408.
24. 李征, 米登海, 杨克虎, 等. 介入化疗栓塞术联合热疗治疗原发性肝癌的Meta分析. 中国循证医学杂志, 2012, 12(6): 672-678.
25. 米登海, 李征, 杨克虎, 等. 热放化三联疗法治疗非小细胞肺癌的Meta分析. 中国循证医学杂志, 2011, 11(11): 1262-1267.
26. 王道英, 李征, 杨克虎, 等. 放疗联合热疗治疗局部晚期非小细胞肺癌疗效与安全性的系统评价. 中国循证医学杂志, 2012, 12(10): 1203-1208.
27. Wust P, Hidebrandt B, Streenivasa G, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol, 2002, 3(8): 489-497.
28. Westermann AM, Wiedemann GJ, Jager E, et al. A Systemic Hyperthermia Oncologic Working Group trial. Ifosfamide, carboplatin, and etoposide combined with 41.8 degrees C whole-body hyperthermia for metastatic soft tissue sarcoma. Oncology, 2003, 64(4): 312-321.
29. Yasuda M, Kondo M, Kokura S, et al. Comparison of concomitant gemcitabine chemotherapy and local hyperthermia, gemcitabine monochemotherapy, and local hyperthermia monotherapy for inoperable progressive pancreatic cancer. J Clin Oncol, 2008, 26(suppl): 15672.
30. National Comprehensive Cancer Network (NCCN). Melanoma. NCCN Clinical Practice Guidelines in Oncology. Washington: PA: NCCN.
31. Brozovic A, Simaga S, Osmak M. Induction of heat shock protein 70 in drug-resistant cells by anticancer drugs and hyperthermia. Neoplasma, 2001, 48(2): 99-103.
32. 徐中林. 恶性肿瘤的热切除治疗. 国外医学(肿瘤学分册), 2002, 29(4): 277.
33. Arends J. Effects of a combined thermochemotherapy on markers of apoptosis, differentiation and adhesion in the human mammary carcinoma MX-1. A light microscopic and immunohistochemical study. Ann Anat, 2000, 182(4): 339-347.
34. Walther W, Stein U, Schlag PM, et al. Use the human MDR1 promoter forheat-inducible expression of therapeutic genes. Int J Cancer, 2002, 98(2): 291-296.
35. Yoo J, Kim HR, Lee YJ. Hyperthermia enhances tumour necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis in human cancer cells. Int J Hyperthermia, 2006, 22(8): 713-728.

Chinese Journal of Evidence-Based Medicine

Chemotherapy Combined with Hyperthermia for Advanced Colorectal Cancer: A Meta-Analysis

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