Article Text
Abstract
Introduction/Background Ovarian cancer is the gynaecological malignancy with the highest mortality.. 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 antiangio-genic therapy. These may improve survival or time to relapse in addition to intravenous chemotherapy.
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).
Methodology A literature search was carried out in Pubmed and Cochrane, selecting clinical studies and systematic reviews published in the last 10 years.
Six studies selected had a study population of 4465 patients for the overall sur-¡vival analysis and 3348 for the disease-free survival analysis.
Statistical analysis was performed using the hazard ratio measure using a fixed-effect model. The results we had shown in forest plot graphs.
RevMan software was used to evaluate the results. (Review Manager (RevMan) Version 5.4, the Cochrane Collaboration, 2020).
Results Intraperitoneal chemotherapy shows a benefit in OS and DFS compared to 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 clinically differences in toxicity and side – effects.
Conclusion Intraperitoneal chemotherapy is an option that could improve OS and DFS without significative toxicity. 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.
Disclosures I have no financial disclosure or conflict of interest with the presented material