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目的探讨腹腔热灌注化疗(hyperthermic intraperitoneal perfusion chemotherapy,HIPC)治疗进展期结直肠癌的临床疗效和安全性。方法应用Meta分析的方法对国内、外已发表的8篇随机对照研究的文献进行定量综合,以结直肠癌根治术后行HIPC治疗的患者为治疗组,以仅施行结直肠癌根治术的患者为对照组,比较2组患者5年生存率和3年生存率的结局变量的相对危险度(RR)及安全性。结果入选的8篇文献共1501例患者,其中治疗组765例,对照组736例,5年生存率的RR为2.39(95%CI:1.66～3.45);3年生存率的RR为2.13(95%CI:1.45～3.13),提示HIPC可提高结直肠癌患者5年和3年生存率,敏感性分析证实该结论较为可靠。入选的5篇文献对HIPC的安全性进行了描述,结果表明HIPC的潜在安全问题较小。结论进展期结直肠癌根治术后行HIPC可以提高生存率,改善患者的预后;是否会增加患者术后并发症发生率目前缺乏相关性研究,尚无明确的结论 。
Objective To investigate the clinical efficacy and safety of hyperthermic intraperitoneal perfusion chemotherapy (HIPC) in the treatment of advanced colorectal cancer. Methods The data of 8 randomized controlled studies published at home and abroad were quantitatively analyzed by means of Meta analysis. The patients undergoing HIPC after radical resection of colorectal cancer were treated, and only patients undergoing radical resection of colorectal cancer As control group, the relative risk (RR) and safety of the outcome variables of 5-year survival and 3-year survival were compared between the two groups. Results A total of 1501 patients were enrolled in the 8 articles, including 765 cases in the treatment group and 736 cases in the control group. The 5-year survival rate was 2.39 (95% CI: 1.66-3.45). The 3-year survival rate was 2.13 % CI: 1.45 ~ 3.13), suggesting that HIPC can improve 5-year and 3-year survival rates of patients with colorectal cancer. Sensitivity analysis confirmed the conclusion is more reliable. The five selected articles described the safety of HIPC and found that the potential safety issues of HIPC are small. Conclusions HIPC after advanced radical resection of colorectal cancer can improve the survival rate and improve the prognosis of patients. Whether there is a correlation study on the incidence of postoperative complications in patients with advanced colorectal cancer is still unclear.