贝伐珠单抗联合顺铂治疗非小细胞肺癌胸腔积液的meta分析

Meta-analysis of Bevacizumab Combined Cisplatin for Non-small Cell Lung Cancer with Malignant Pleural Effusion

目的系统评价贝伐珠单抗联合顺铂腔内注射治疗非小细胞肺癌胸腔积液的有效性和安全性。方法计算机检索PubMed、Embase、Cochrane图书馆、万方数据库、中国学术文献出版总库(China National Knowledge Infrastructure,CNKI)、中国生物医学文献数据库(Chinese Biomedical Literature Database)、维普电子期刊全文数据库等。2名评价员独立评价纳入研究的文献质量并提取资料,使用RevMan5.3软件进行统计分析。结果共纳入6项随机对照试验(randomized control trial,RCT),共371例患者。Meta分析结果显示:贝伐珠单抗联合顺铂能显著提高非小细胞肺癌胸腔积液治疗的有效率(OR=3.40,95%CI:2.12~5.45,P<0.00001),明显降低胸腔积液内血管内皮生长因子(vascular endothelial growth factor,VEGF)的含量(MD=59.53,95%CI:42.85~76.22,P<0.00001),同时不会增加不良反应的发生率。结论贝伐珠单抗联合顺铂腔内注射可以缓解和控制恶性胸水,且安全性良好。

Objective To evaluate the efficacy and safety of bevacizumab combined cisplatin for non-small cell lung cancer with malignant pleural effusion by meta-analysis. Methods Randomized control trial （RCT） on bevaeizumab com- bined with cisplatin in treatment of malignant pleural effusion were selected from databases： Pubmed, Enbase, Cochrane Library, Chinese Biomedical Literature Dctabase, China National Knowledge Infrastructure（CNKI）, Wanfang Database, Chinese VIP Journal Database, China Biology Medicine disc（CBMdisc） and so on. The literature were collected and inde- pendently evaluated by two evaluators using RevMan 5. 3. Results Six RCTs were involved for a total of 371 patients. Meta-analysis results indicated that bevacizumab plus cisplatin obviously improved treatment efficacy （OR = 3. 40,95 % CI： 2. 12-5. 45, P〈0. 000 01） and markedly decreased the quantities of vascular endothelial growth factor （VEGF） in pleu- ral effusion （MD = 59. 53, 95%CI：42. 85-76. 22, P〈0. 000 01）. In addition, there was no difference in adverse events between bevacizumab groups and control groups. Conclusion Bevacizumab combine cisplatin intrapleural injection is obvi- ously effective and safe in treatment of non-small cell lung cancer with malignant pleural effusion.