Effectiveness and Safety of Hyperthermia plus Intraperitoneal Hyperthermic Perfusion Chemotherapy for Malignant Ascites: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

HOU Yangshao ¹ ,  SHI Hongping ²

1. Chinese Medicine Hospital of Heze City of Shandong Province, Heze 274200, China;2. The First Clinical Medicine College, Lanzhou University, Lanzhou 730000, China;

Corresponding author：

SHI Hongping, Email: 115434263@qq.com

Keywords：

Hyperthermia; Intraperitoneal hyperthermic perfusion chemotherapy; Malignant ascites; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20130213

Video：

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Abstract Full text Figures/Tables Video References Cited by

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, P lt;0.000 01), better improvement in quality of life (OR=2.77, 95%CI 1.90 to 4.05, P lt;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.

Citation： HOU Yangshao,SHI Hongping. Effectiveness and Safety of Hyperthermia plus Intraperitoneal Hyperthermic Perfusion Chemotherapy for Malignant Ascites: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(10): 1244-1250. doi: 10.7507/1672-2531.20130213 Copy

1.	安永恒, 丁爱萍, 梁军. 肿瘤合理用药. 第2 版. 北京: 人民卫生出版社, 2009: 437-438．.
2.	Wust P, Hildebrandt B, Sreenivasa G, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol, 2002, 3(8): 487-497.
3.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008].The Cochrane Collaboration, 2008. Available from: www.Cochrane-handbook.org.
4.	Review Manager. The Cochrane Collaboration. Copenhagen: The Nordic Cochrane Centre, 2008.
5.	邢雪花, 王琳, 刘华, 等. 腹腔闭式引流结合腹腔化疗及热疗治疗恶性腹水的临床观察. 中华肿瘤防治杂志, 2007, 14(24): 1898-1899, 1902.
6.	殷娟, 戴鹏, 谢正强. 腹腔热灌注化疗联合高频热疗治疗恶性腹水. 武汉大学学报(医学版), 2007, 28(2): 248-250.
7.	赵忠全, 欧阳学农, 刘志臻. 腹腔热灌注化疗联合射频热疗治疗恶性腹腔积液的临床观察. 福州总医院学报, 2010, 17(4): 249-250, 223.
8.	罗展雄, 倪秉强, 郑青平, 等. 腹腔热化疗治疗卵巢癌合并腹水临床疗效观察. 中国肿瘤临床与康复, 2009, 16(5): 428-430.
9.	张晨瑶, 王丽茹, 孙巍. 热疗联合灌注治疗癌性腹腔积液的临床观察. 当代医学, 2011, 17(19): 109-110.
10.	刘卓, 徐丽贤, 吴耀芳, 等. 射频热疗联合腹腔化疗治疗癌性腹腔积液的疗效观察. 癌症进展, 2011, 9(6): 722-724.
11.	徐伟, 吕晓萍, 张艳, 等. 射频热疗联合腹腔热灌注化疗治疗恶性腹腔积液近期疗效观察. 中华物理医学与康复杂志, 2006, 28(11): 786-787.
12.	胡忠东, 钟美佐, 姜斌, 等. 顺铂和白介素-2腹腔灌注化疗联合射频热疗治疗癌性腹水的疗效观察. 医学临床研究, 2010, 27(6): 1084-1086.
13.	李艳芳. 探究射频热疗在恶性腹水治疗中的临床疗效. 医药论坛杂志, 2011, 32(14): 4-6.
14.	费燕华, 王南瑶, 王琼, 等. 香菇多糖联合化疗药物腹腔灌注结合热疗治疗恶性腹水的临床分析. 中国医师进修杂志, 2011, 34(33): 68-69.
15.	于淑真. 腹腔灌注化疗联合腹部局部热疗和利尿剂治疗恶性腹水38例疗效观察. 中国社区医师(医学专业), 2012, 14(7): 88.
16.	罗文娟, 吴文涛, 卢萍. 顺铂5-Fu联合腹腔化疗+热疗与单纯腹腔化疗治疗癌性腹水疗效观察. 四川医学, 2005, 26(8): 867-868.
17.	徐敬根, 张静. 顺铂腹腔热灌注并微波局部热疗对癌性腹水的疗效观察. 安徽医药, 2009, 13(2): 196-197.
18.	张念华, 陈高峰, 史清华, 等. 腹腔灌注化疗联合内生场热疗在胰腺癌恶性腹水中的应用研究. 新医学, 2012, 43(1): 19-22.
19.	王太勇, 程玉峰. 腹腔热灌注化疗对恶性腹水的疗效观察. 国际肿瘤学杂志, 2006, 33(11): 877-879.
20.	李海金, 董良, 陈亚男, 等. 恶性腹腔积液体外高频深部热疗联合腹腔化疗的临床观察. 中华肿瘤防治杂志, 2011, (19): 1559-1562.
21.	安永恒, 丁爱萍, 梁军. 肿瘤合理用药. 第2 版. 北京: 人民卫生出版社, 2009: 437-438.
22.	黎世蓉, 薛志红, 郑晓梅. 腹腔化疗联合腹部热疗治疗癌性腹水的疗效观察及护理. 当代医学, 2009, 15(25): 10-11.
23.	Lutgens L, vander Zee J, Pijls-Johannesma M, et al. Combined use of hyperthermiaand radiation therapy for treating locally advanced cervical carcinoma. Cochrane Database Syst Rev, 2010, 1: CD006377.
24.	Yan TD, Black D, Sugarbaker PH, et al. A systematic review and meta-analysis of the randomized controlled trials on adjuvant intraperitoneal chemotherapy for resectable gastric cancer. Ann Surg Oncol, 2007, 14(10): 2702-2713.
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.	Chua TC, Robertson G, Liauw W, et al. Intraoperative hyperthermic intraperitoneal chemotherapy after cytoreductive surgery in ovarian cancer peritoneal carcinomatosis: systematic review of current results . J Cancer ResClin Oncol, 2009, 135 (12): 1637-1645.
27.	Gill RS, Al-Adra DP, Nagendran J, et al. Treatment of gastric cancer with peritoneal carcinomatosis by cytoreductive surgery and HIPEC: a systematic review of survival, mortality, and morbidity. J Surg Oncol, 2011, 104(6): 692-698.

1. 安永恒, 丁爱萍, 梁军. 肿瘤合理用药. 第2 版. 北京: 人民卫生出版社, 2009: 437-438．.
2. Wust P, Hildebrandt B, Sreenivasa G, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol, 2002, 3(8): 487-497.
3. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008].The Cochrane Collaboration, 2008. Available from: www.Cochrane-handbook.org.
4. Review Manager. The Cochrane Collaboration. Copenhagen: The Nordic Cochrane Centre, 2008.
5. 邢雪花, 王琳, 刘华, 等. 腹腔闭式引流结合腹腔化疗及热疗治疗恶性腹水的临床观察. 中华肿瘤防治杂志, 2007, 14(24): 1898-1899, 1902.
6. 殷娟, 戴鹏, 谢正强. 腹腔热灌注化疗联合高频热疗治疗恶性腹水. 武汉大学学报(医学版), 2007, 28(2): 248-250.
7. 赵忠全, 欧阳学农, 刘志臻. 腹腔热灌注化疗联合射频热疗治疗恶性腹腔积液的临床观察. 福州总医院学报, 2010, 17(4): 249-250, 223.
8. 罗展雄, 倪秉强, 郑青平, 等. 腹腔热化疗治疗卵巢癌合并腹水临床疗效观察. 中国肿瘤临床与康复, 2009, 16(5): 428-430.
9. 张晨瑶, 王丽茹, 孙巍. 热疗联合灌注治疗癌性腹腔积液的临床观察. 当代医学, 2011, 17(19): 109-110.
10. 刘卓, 徐丽贤, 吴耀芳, 等. 射频热疗联合腹腔化疗治疗癌性腹腔积液的疗效观察. 癌症进展, 2011, 9(6): 722-724.
11. 徐伟, 吕晓萍, 张艳, 等. 射频热疗联合腹腔热灌注化疗治疗恶性腹腔积液近期疗效观察. 中华物理医学与康复杂志, 2006, 28(11): 786-787.
12. 胡忠东, 钟美佐, 姜斌, 等. 顺铂和白介素-2腹腔灌注化疗联合射频热疗治疗癌性腹水的疗效观察. 医学临床研究, 2010, 27(6): 1084-1086.
13. 李艳芳. 探究射频热疗在恶性腹水治疗中的临床疗效. 医药论坛杂志, 2011, 32(14): 4-6.
14. 费燕华, 王南瑶, 王琼, 等. 香菇多糖联合化疗药物腹腔灌注结合热疗治疗恶性腹水的临床分析. 中国医师进修杂志, 2011, 34(33): 68-69.
15. 于淑真. 腹腔灌注化疗联合腹部局部热疗和利尿剂治疗恶性腹水38例疗效观察. 中国社区医师(医学专业), 2012, 14(7): 88.
16. 罗文娟, 吴文涛, 卢萍. 顺铂5-Fu联合腹腔化疗+热疗与单纯腹腔化疗治疗癌性腹水疗效观察. 四川医学, 2005, 26(8): 867-868.
17. 徐敬根, 张静. 顺铂腹腔热灌注并微波局部热疗对癌性腹水的疗效观察. 安徽医药, 2009, 13(2): 196-197.
18. 张念华, 陈高峰, 史清华, 等. 腹腔灌注化疗联合内生场热疗在胰腺癌恶性腹水中的应用研究. 新医学, 2012, 43(1): 19-22.
19. 王太勇, 程玉峰. 腹腔热灌注化疗对恶性腹水的疗效观察. 国际肿瘤学杂志, 2006, 33(11): 877-879.
20. 李海金, 董良, 陈亚男, 等. 恶性腹腔积液体外高频深部热疗联合腹腔化疗的临床观察. 中华肿瘤防治杂志, 2011, (19): 1559-1562.
21. 安永恒, 丁爱萍, 梁军. 肿瘤合理用药. 第2 版. 北京: 人民卫生出版社, 2009: 437-438.
22. 黎世蓉, 薛志红, 郑晓梅. 腹腔化疗联合腹部热疗治疗癌性腹水的疗效观察及护理. 当代医学, 2009, 15(25): 10-11.
23. Lutgens L, vander Zee J, Pijls-Johannesma M, et al. Combined use of hyperthermiaand radiation therapy for treating locally advanced cervical carcinoma. Cochrane Database Syst Rev, 2010, 1: CD006377.
24. Yan TD, Black D, Sugarbaker PH, et al. A systematic review and meta-analysis of the randomized controlled trials on adjuvant intraperitoneal chemotherapy for resectable gastric cancer. Ann Surg Oncol, 2007, 14(10): 2702-2713.
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. Chua TC, Robertson G, Liauw W, et al. Intraoperative hyperthermic intraperitoneal chemotherapy after cytoreductive surgery in ovarian cancer peritoneal carcinomatosis: systematic review of current results . J Cancer ResClin Oncol, 2009, 135 (12): 1637-1645.
27. Gill RS, Al-Adra DP, Nagendran J, et al. Treatment of gastric cancer with peritoneal carcinomatosis by cytoreductive surgery and HIPEC: a systematic review of survival, mortality, and morbidity. J Surg Oncol, 2011, 104(6): 692-698.

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Effectiveness and Safety of Hyperthermia plus Intraperitoneal Hyperthermic Perfusion Chemotherapy for Malignant Ascites: A Meta-Analysis

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