热疗联合静脉化疗治疗晚期卵巢癌的效果及安全性的Meta分析
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摘要
目的系统评价热疗联合静脉化疗治疗卵巢癌的有效性和安全性。方法计算机检索Pub Med、Cochrane library、EMbase、中国学术期刊全文数据库、中国生物医学文献数据库等,搜索年限从建库到2017年6月22日。纳入热疗联合静脉化疗治疗卵巢癌效果与安全性方面的随机对照研究。使用Cochrane手册5.1.0版的质量评价标准对纳入研究进行质量评价,使用Rev Man 5.1.0版软件进行数据分析。结果最终纳入20项研究,共1275例患者。Meta分析结果显示:与对照组比较,治疗组有效率[RR=1.58,95%CI:1.42~1.77,P<0.00 001],腹水有效率[RR=1.63,95%CI:1.32~2.02,P<0.00 001],CA125有效率[RR=1.33,95%CI:1.14~1.55,P=0.0003],生活质量改善率[RR=1.60,95%CI:1.24~2.06,P=0.0003]均提高。热疗联合静脉化疗并不增加骨髓抑制、恶心呕吐、肝肾损害等的发生率(P>0.05)。结论热疗联合静脉化疗可提高卵巢癌的疗效,改善生活质量,且不增加毒副作用。
Objective To evaluate the effectiveness and safety of hyperthermia combined with intravenous chemotherapy for ovarian cancer.Methods The databases of Pub Med,Cochrane library,EMbase,China national knowledge internet,the Chinese biomedical literature database were searched from building to June 22,2017.Randomized controlled studies on the efficacy and safety of hyperthermia combined with intravenous chemotherapy in the treatment of ovarian cancer were included,the quality of the included studies was evaluated using the quality evaluation criteria of the Cochrane Handbook version 5.1.0,and the Review Manager 5.1.0 software was used for data analysis.Results Twenty studies including 1275 cases of ovarian cancer were included.The results of the Meta-analysis exhibited that compared with intravenous chemotherapy alone,hyperthermia combined with intravenous chemotherapy could increase effective rate [RR =1.58,95%CI:1.42-1.77,P < 0.00 001],effective rate of ascites[RR = 1.63,95%CI:1.32-2.02,P < 0.00 001],effective rate of CA125 [RR = 1.33,95%CI:1.14-1.55,P = 0.0003],the improvement rate of life quality [RR = 1.60,95%CI:1.24-2.06,P = 0.0003].Meanwhile,hyperthermia combined with intravenous chemotherapy did not significantly increase the incidence of myelosuppression,nausea and vomiting and liver and kidney dysfunction(P > 0.05).Conclusion Hyperthermia combined with intravenous chemotherapy may be more effective for ovarian cancer,improve life quality whereas adverse reactions are similar.
Objective To evaluate the effectiveness and safety of hyperthermia combined with intravenous chemotherapy for ovarian cancer.Methods The databases of Pub Med,Cochrane library,EMbase,China national knowledge internet,the Chinese biomedical literature database were searched from building to June 22,2017.Randomized controlled studies on the efficacy and safety of hyperthermia combined with intravenous chemotherapy in the treatment of ovarian cancer were included,the quality of the included studies was evaluated using the quality evaluation criteria of the Cochrane Handbook version 5.1.0,and the Review Manager 5.1.0 software was used for data analysis.Results Twenty studies including 1275 cases of ovarian cancer were included.The results of the Meta-analysis exhibited that compared with intravenous chemotherapy alone,hyperthermia combined with intravenous chemotherapy could increase effective rate [RR =1.58,95%CI:1.42-1.77,P < 0.00 001],effective rate of ascites[RR = 1.63,95%CI:1.32-2.02,P < 0.00 001],effective rate of CA125 [RR = 1.33,95%CI:1.14-1.55,P = 0.0003],the improvement rate of life quality [RR = 1.60,95%CI:1.24-2.06,P = 0.0003].Meanwhile,hyperthermia combined with intravenous chemotherapy did not significantly increase the incidence of myelosuppression,nausea and vomiting and liver and kidney dysfunction(P > 0.05).Conclusion Hyperthermia combined with intravenous chemotherapy may be more effective for ovarian cancer,improve life quality whereas adverse reactions are similar.
引文
[1]胡远强,张永波,王华,等.多西他赛联合卡铂与紫杉醇联合顺铂治疗晚期卵巢癌的疗效和安全性比较[J].中国药房,2016,27(24):3353-3356.
[2]张晶,胡泽成,陈忠东.静脉联合洛铂腹腔恒温循环热灌注化疗对晚期卵巢癌的疗效研究[J].中国医学创新,2015,12(11):1-4.
[3]Siegel R,Naishadham D,Jemal A.Cancer statistics,2012[J].CA Cancer J Clin,2012,62(1):10-29.
[4]孙燕.临床肿瘤内科手册[M].2版.北京:人民卫生出版社,2001:994.
[5]饶明月,吴敬波,林盛,等.深部热疗联合化疗治疗晚期卵巢癌近期疗效临床观察[J].中华临床医师杂志,2014,8(11):1997-2001.
[6]丁娟,符慧群.44例热化疗在卵巢癌中的临床观察分析[J].实用预防医学,2006,13(3):725-726.
[7]李丽华,任洪军.TP方案配合腹腔热化疗治疗上皮型中晚期卵巢癌临床研究[J].肿瘤基础与临床,2006,19(3):247-248.
[8]王允,贾霖,高飞,等.腹腔热灌注化疗联合静脉化疗治疗卵巢癌伴腹腔积液的临床观察[J].肿瘤基础与临床,2007,20(3):268-269.
[9]李小瑞,杨军,孙蔚亮,等.腹腔灌注及静脉化疗配合热疗治疗晚期卵巢癌的临床观察[J].医学信息,2009,22(2):131-132.
[10]梁冰,杨家梅,贺新伟.全身化疗联合腹腔热灌注化疗并射频热疗治疗晚期卵巢癌[J].医药论坛杂志,2009(24):57-58.
[11]张明.多西他赛联合顺铂及热疗治疗晚期卵巢癌疗效观察与护理[J].国际护理学杂志,2010,29(2):180-182.
[12]李雅琪,龚勋,杨炜婷,等.卵巢癌术后腹腔热化疗联合静脉化疗的疗效观察[J].现代医学,2011,39(4):409-411.
[13]田玉青,马印慧,董丽娟,等.晚期卵巢癌TP方案化疗联合热疗疗效观察及护理[J].西部医学,2012,24(6):1193-1194.
[14]余志红,胡仙珍,徐仙凤,等.肿瘤深部射频热疗在晚期卵巢癌化疗中的作用[J].实用医学杂志,2013,29(2):245-247.
[15]梁秀菊,楚慧丽,王俊,等.多西他赛联合腹腔热灌注化疗加热疗治疗晚期卵巢癌[J].中国肿瘤临床,2013,40(17):1051-1054.
[16]崔勇,张荣香,王福立,等,BSD2000相控阵聚焦深部热疗联合TP方案化疗治疗晚期卵巢癌的临床效果[J].山东大学学报:医学版,2015,53(7):53-57.
[17]郑连喜.多西他赛联合腹腔热灌注化疗加热疗治疗晚期卵巢癌[J].中国肿瘤临床与康复,2014,21(6):733-735.
[18]莫佳萍,王增,刘南芳.腹腔热疗联合TP方案治疗中晚期卵巢癌的临床观察[J].中国药房,2014,25(22):2053-2055.
[19]杨越,张蕾,崔瑶,等.全身化疗联合腹腔热灌注化疗并射频热疗治疗晚期卵巢癌[J].肿瘤基础与临床,2014,(3):213-214.
[20]陈雍,王根和.深部热疗与化疗结合治疗晚期卵巢癌的临床疗效研究[J].今日健康,2015,14(12):50.
[21]朱保江.肿瘤深部射频热疗在晚期卵巢癌化疗中的作用分析[J].中国实用医刊,2015,42(13):105-106.
[22]李淑蓉.卵巢癌晚期实施腹腔热灌注化疗的近期效果评析[J].中国处方药,2016,14(4):129-130.
[23]申婧,曹海英.深部热频治疗对晚期卵巢癌的疗效影响[J].中外女性健康研究,2016(5):204-204.
[24]黄相艳,李秀芳,孟泳圳.深部热疗联合化疗治疗复发性卵巢癌的近期疗效观察[J].医学与哲学,2017,38(8):34-36.
[25]Raut CP,Evans DB,Crane CH,et al.Neoadjuvant therapy for ispectable pancreatic cancer[J].Surg Oncol Clin North Am,2004,13(4):639-661.
[26]常娜,朱晓菊,付文娟,等.腹腔热灌注治疗恶性腹水的临床效果[J].中国医药导报,2016,13(23):110-113,125.
[27]赵玲俊,李佳,姜丽真,等.进展期胃癌热疗联合其他治疗的进展[J].中国医药导报,2015,12(24):57-60.
[2]张晶,胡泽成,陈忠东.静脉联合洛铂腹腔恒温循环热灌注化疗对晚期卵巢癌的疗效研究[J].中国医学创新,2015,12(11):1-4.
[3]Siegel R,Naishadham D,Jemal A.Cancer statistics,2012[J].CA Cancer J Clin,2012,62(1):10-29.
[4]孙燕.临床肿瘤内科手册[M].2版.北京:人民卫生出版社,2001:994.
[5]饶明月,吴敬波,林盛,等.深部热疗联合化疗治疗晚期卵巢癌近期疗效临床观察[J].中华临床医师杂志,2014,8(11):1997-2001.
[6]丁娟,符慧群.44例热化疗在卵巢癌中的临床观察分析[J].实用预防医学,2006,13(3):725-726.
[7]李丽华,任洪军.TP方案配合腹腔热化疗治疗上皮型中晚期卵巢癌临床研究[J].肿瘤基础与临床,2006,19(3):247-248.
[8]王允,贾霖,高飞,等.腹腔热灌注化疗联合静脉化疗治疗卵巢癌伴腹腔积液的临床观察[J].肿瘤基础与临床,2007,20(3):268-269.
[9]李小瑞,杨军,孙蔚亮,等.腹腔灌注及静脉化疗配合热疗治疗晚期卵巢癌的临床观察[J].医学信息,2009,22(2):131-132.
[10]梁冰,杨家梅,贺新伟.全身化疗联合腹腔热灌注化疗并射频热疗治疗晚期卵巢癌[J].医药论坛杂志,2009(24):57-58.
[11]张明.多西他赛联合顺铂及热疗治疗晚期卵巢癌疗效观察与护理[J].国际护理学杂志,2010,29(2):180-182.
[12]李雅琪,龚勋,杨炜婷,等.卵巢癌术后腹腔热化疗联合静脉化疗的疗效观察[J].现代医学,2011,39(4):409-411.
[13]田玉青,马印慧,董丽娟,等.晚期卵巢癌TP方案化疗联合热疗疗效观察及护理[J].西部医学,2012,24(6):1193-1194.
[14]余志红,胡仙珍,徐仙凤,等.肿瘤深部射频热疗在晚期卵巢癌化疗中的作用[J].实用医学杂志,2013,29(2):245-247.
[15]梁秀菊,楚慧丽,王俊,等.多西他赛联合腹腔热灌注化疗加热疗治疗晚期卵巢癌[J].中国肿瘤临床,2013,40(17):1051-1054.
[16]崔勇,张荣香,王福立,等,BSD2000相控阵聚焦深部热疗联合TP方案化疗治疗晚期卵巢癌的临床效果[J].山东大学学报:医学版,2015,53(7):53-57.
[17]郑连喜.多西他赛联合腹腔热灌注化疗加热疗治疗晚期卵巢癌[J].中国肿瘤临床与康复,2014,21(6):733-735.
[18]莫佳萍,王增,刘南芳.腹腔热疗联合TP方案治疗中晚期卵巢癌的临床观察[J].中国药房,2014,25(22):2053-2055.
[19]杨越,张蕾,崔瑶,等.全身化疗联合腹腔热灌注化疗并射频热疗治疗晚期卵巢癌[J].肿瘤基础与临床,2014,(3):213-214.
[20]陈雍,王根和.深部热疗与化疗结合治疗晚期卵巢癌的临床疗效研究[J].今日健康,2015,14(12):50.
[21]朱保江.肿瘤深部射频热疗在晚期卵巢癌化疗中的作用分析[J].中国实用医刊,2015,42(13):105-106.
[22]李淑蓉.卵巢癌晚期实施腹腔热灌注化疗的近期效果评析[J].中国处方药,2016,14(4):129-130.
[23]申婧,曹海英.深部热频治疗对晚期卵巢癌的疗效影响[J].中外女性健康研究,2016(5):204-204.
[24]黄相艳,李秀芳,孟泳圳.深部热疗联合化疗治疗复发性卵巢癌的近期疗效观察[J].医学与哲学,2017,38(8):34-36.
[25]Raut CP,Evans DB,Crane CH,et al.Neoadjuvant therapy for ispectable pancreatic cancer[J].Surg Oncol Clin North Am,2004,13(4):639-661.
[26]常娜,朱晓菊,付文娟,等.腹腔热灌注治疗恶性腹水的临床效果[J].中国医药导报,2016,13(23):110-113,125.
[27]赵玲俊,李佳,姜丽真,等.进展期胃癌热疗联合其他治疗的进展[J].中国医药导报,2015,12(24):57-60.