PDF(Pubmed)
Abstract：
BACKGROUND: Ovarian cancer is the gynaecological malignancy with the highest mortality and diagnosis often occurs in its advanced stages. Standard treatment in these cases is based on complete cytoreductive surgery with adjuvant intravenous chemotherapy. Other types of treatment are being evaluated to improve the prognosis of these patients, including intraperitoneal chemotherapy and antiangiogenic therapy. These may improve survival or time to relapse in addition to intravenous chemotherapy.
OBJECTIVE: The aim of this meta-analysis is to determine whether treatment with intravenous chemotherapy remains the gold standard, or whether the addition of intraperitoneal chemotherapy has a benefit in overall survival (OS) and disease-free interval (DFS).
METHODS: A literature search was carried out in Pubmed and Cochrane, selecting clinical studies and systematic reviews published in the last 10 years. Statistical analysis was performed using the hazard ratio measure in the RevMan tool.
RESULTS: Intraperitoneal chemotherapy shows a benefit in OS and DFS compared with standard intravenous chemotherapy. The significant differences in OS (HR: 0.81 CI 95% 0.74-0.88) and in DFS (HR: 0.81 CI 95% 0.75-0.87) are statistically significant (p < 0.00001). There were no clinical differences in toxicity and side-effects.
CONCLUSIONS: Intraperitoneal chemotherapy is an option that improves OS and DFS without significant toxicity regarding the use of intravenous chemotherapy alone. However, prospective studies are needed to determine the optimal dose and treatment regimen that will maintain the benefits while minimising side effects and toxicity and the profile of patients who will benefit most from this treatment.
OBJECTIVE: The aim of this meta-analysis is to determine whether treatment with intravenous chemotherapy remains the gold standard, or whether the addition of intraperitoneal chemotherapy has a benefit in overall survival (OS) and disease-free interval (DFS).
METHODS: A literature search was carried out in Pubmed and Cochrane, selecting clinical studies and systematic reviews published in the last 10 years. Statistical analysis was performed using the hazard ratio measure in the RevMan tool.
RESULTS: Intraperitoneal chemotherapy shows a benefit in OS and DFS compared with standard intravenous chemotherapy. The significant differences in OS (HR: 0.81 CI 95% 0.74-0.88) and in DFS (HR: 0.81 CI 95% 0.75-0.87) are statistically significant (p < 0.00001). There were no clinical differences in toxicity and side-effects.
CONCLUSIONS: Intraperitoneal chemotherapy is an option that improves OS and DFS without significant toxicity regarding the use of intravenous chemotherapy alone. However, prospective studies are needed to determine the optimal dose and treatment regimen that will maintain the benefits while minimising side effects and toxicity and the profile of patients who will benefit most from this treatment.
摘要：
背景：卵巢癌是死亡率最高的妇科恶性肿瘤，诊断通常发生在晚期。在这些情况下，标准治疗基于完整的细胞减灭术和辅助静脉化疗。正在评估其他类型的治疗方法，以改善这些患者的预后，包括腹膜内化疗和抗血管生成治疗。除静脉化疗外，这些药物还可以改善生存率或复发时间。
目的：本荟萃分析的目的是确定静脉化疗治疗是否仍然是金标准，或增加腹腔内化疗是否对总生存期(OS)和无病间期(DFS)有益处。
方法：在Pubmed和Cochrane进行了文献检索，选择最近10年发表的临床研究和系统评价。使用RevMan工具中的风险比度量进行统计分析。
结果：与标准静脉化疗相比，腹膜内化疗显示出OS和DFS的益处。OS(HR:0.81CI95%0.74-0.88)和DFS(HR:0.81CI95%0.75-0.87)的显著差异有统计学意义(p<0.00001)。在毒性和副作用方面没有临床差异。
结论：腹膜内化疗是一种改善OS和DFS的选择，对于单独使用静脉化疗没有显著毒性。然而,需要进行前瞻性研究,以确定最佳剂量和治疗方案,以保持获益,同时最大限度地减少副作用和毒性,以及从这种治疗中获益最多的患者的情况.
目的：本荟萃分析的目的是确定静脉化疗治疗是否仍然是金标准，或增加腹腔内化疗是否对总生存期(OS)和无病间期(DFS)有益处。
方法：在Pubmed和Cochrane进行了文献检索，选择最近10年发表的临床研究和系统评价。使用RevMan工具中的风险比度量进行统计分析。
结果：与标准静脉化疗相比，腹膜内化疗显示出OS和DFS的益处。OS(HR:0.81CI95%0.74-0.88)和DFS(HR:0.81CI95%0.75-0.87)的显著差异有统计学意义(p<0.00001)。在毒性和副作用方面没有临床差异。
结论：腹膜内化疗是一种改善OS和DFS的选择，对于单独使用静脉化疗没有显著毒性。然而,需要进行前瞻性研究,以确定最佳剂量和治疗方案,以保持获益,同时最大限度地减少副作用和毒性,以及从这种治疗中获益最多的患者的情况.
