Abstract：
OBJECTIVE: We aimed to compare the survival outcomes and adverse events of hyperthermic intraperitoneal chemotherapy (HIPEC), intraperitoneal chemotherapy (IP)and intravenous chemotherapy (IP)for primary advanced ovarian cancer.
METHODS: PubMed, CENTRAL (Cochrane Central Registry of Controlled Trials), Embase, Web of Science and Scopus were searched using multiple terms for primary advanced ovarian cancer, including randomized controlled trials and comparative studies in both Chinese and English (up to date 15 August 2022). Outcomes include overall survival, progression-free survival and adverse events. The data were pooled and reported as hazard ratio (HRs) with 95% confidence intervals. The Newcastle-Ottawa Scales were used to assess the risk of bias in the included comparative study. The Cochrane Collaboration\'s Risk of Bias Tool was used for randomized controlled trials.
RESULTS: In total, 32 studies, including 6347 patients and 8 different platinum-based chemotherapy regimens, were included in this network meta-analysis. Our analysis results showed that HIPEC2 (carboplatin with area under the curve 10) exhibited a statistically significant OS benefit compared to IV, weekly dose-dense chemotherapy and HIPEC1 (cisplatin with 75/100 mg/m2). Intraperitoneal plus intravenous chemotherapy was associated with a statistically significantly better likelihood of overall survival compared to IV. For progression-free survival, our statistical results only suggest a better progression-free survival in ovarian cancer patients treated with HIPEC1 compared with weekly dose-dense chemotherapy. No evidence of difference was observed between the other comparison groups. Compared with the non-HIPEC group, HIPEC may had a higher incidence of electrolyte disturbances (≥grade 3).
CONCLUSIONS: Our statistical analysis suggests that the groups receiving HIPEC2 had a better OS than the groups receiving IV, weekly dose-dense chemotherapy and HIPEC1. For PFS, our analysis only showed HIPEC1 is better than IV. Moreover, HIPEC may lead to a higher incidence of electrolyte disturbances (≥grade 3). HIPEC therapy for advanced ovarian cancer is currently controversial.
METHODS: PubMed, CENTRAL (Cochrane Central Registry of Controlled Trials), Embase, Web of Science and Scopus were searched using multiple terms for primary advanced ovarian cancer, including randomized controlled trials and comparative studies in both Chinese and English (up to date 15 August 2022). Outcomes include overall survival, progression-free survival and adverse events. The data were pooled and reported as hazard ratio (HRs) with 95% confidence intervals. The Newcastle-Ottawa Scales were used to assess the risk of bias in the included comparative study. The Cochrane Collaboration\'s Risk of Bias Tool was used for randomized controlled trials.
RESULTS: In total, 32 studies, including 6347 patients and 8 different platinum-based chemotherapy regimens, were included in this network meta-analysis. Our analysis results showed that HIPEC2 (carboplatin with area under the curve 10) exhibited a statistically significant OS benefit compared to IV, weekly dose-dense chemotherapy and HIPEC1 (cisplatin with 75/100 mg/m2). Intraperitoneal plus intravenous chemotherapy was associated with a statistically significantly better likelihood of overall survival compared to IV. For progression-free survival, our statistical results only suggest a better progression-free survival in ovarian cancer patients treated with HIPEC1 compared with weekly dose-dense chemotherapy. No evidence of difference was observed between the other comparison groups. Compared with the non-HIPEC group, HIPEC may had a higher incidence of electrolyte disturbances (≥grade 3).
CONCLUSIONS: Our statistical analysis suggests that the groups receiving HIPEC2 had a better OS than the groups receiving IV, weekly dose-dense chemotherapy and HIPEC1. For PFS, our analysis only showed HIPEC1 is better than IV. Moreover, HIPEC may lead to a higher incidence of electrolyte disturbances (≥grade 3). HIPEC therapy for advanced ovarian cancer is currently controversial.
摘要：
目的：我们旨在比较腹腔热化疗（HIPEC）的生存结果和不良事件，原发性晚期卵巢癌的腹腔化疗(IP)和静脉化疗(IP)。
方法：PubMed，CENTRAL（Cochrane中央控制试验登记处），Embase,WebofScience和Scopus使用多个术语搜索原发性晚期卵巢癌，包括中文和英文的随机对照试验和比较研究（截止日期为2022年8月15日）。结果包括总体生存率，无进展生存期和不良事件。将数据汇总并报告为具有95%置信区间的风险比(HRs)。在纳入的比较研究中，使用纽卡斯尔-渥太华量表评估偏倚风险。Cochrane协作的风险偏差工具用于随机对照试验。
结果：总计，32项研究,包括6347例患者和8种不同的铂类化疗方案，被包括在这个网络荟萃分析中。我们的分析结果表明，与IV相比，HIPEC2（具有曲线下面积的卡铂10）表现出统计学上显着的OS益处，每周剂量密集化疗和HIPEC1（顺铂75/100mg/m2）。与IV相比，腹膜内联合静脉化疗与统计学上显着更好的总体生存可能性相关。对于无进展生存期，我们的统计结果仅表明,与每周剂量密集化疗相比,接受HIPEC1治疗的卵巢癌患者的无进展生存期更好.在其他比较组之间没有观察到差异的证据。与非HIPEC组相比，HIPEC的电解质紊乱发生率较高（≥3级）。
结论：我们的统计分析表明，接受HIPEC2的组的OS优于接受IV的组，每周剂量密集化疗和HIPEC1。对于PFS，我们的分析仅显示HIPEC1优于IV。此外，HIPEC可能导致更高的电解质紊乱发生率(≥3级)。HIPEC治疗晚期卵巢癌目前存在争议。
方法：PubMed，CENTRAL（Cochrane中央控制试验登记处），Embase,WebofScience和Scopus使用多个术语搜索原发性晚期卵巢癌，包括中文和英文的随机对照试验和比较研究（截止日期为2022年8月15日）。结果包括总体生存率，无进展生存期和不良事件。将数据汇总并报告为具有95%置信区间的风险比(HRs)。在纳入的比较研究中，使用纽卡斯尔-渥太华量表评估偏倚风险。Cochrane协作的风险偏差工具用于随机对照试验。
结果：总计，32项研究,包括6347例患者和8种不同的铂类化疗方案，被包括在这个网络荟萃分析中。我们的分析结果表明，与IV相比，HIPEC2（具有曲线下面积的卡铂10）表现出统计学上显着的OS益处，每周剂量密集化疗和HIPEC1（顺铂75/100mg/m2）。与IV相比，腹膜内联合静脉化疗与统计学上显着更好的总体生存可能性相关。对于无进展生存期，我们的统计结果仅表明,与每周剂量密集化疗相比,接受HIPEC1治疗的卵巢癌患者的无进展生存期更好.在其他比较组之间没有观察到差异的证据。与非HIPEC组相比，HIPEC的电解质紊乱发生率较高（≥3级）。
结论：我们的统计分析表明，接受HIPEC2的组的OS优于接受IV的组，每周剂量密集化疗和HIPEC1。对于PFS，我们的分析仅显示HIPEC1优于IV。此外，HIPEC可能导致更高的电解质紊乱发生率(≥3级)。HIPEC治疗晚期卵巢癌目前存在争议。
