热灌注化疗联合贝伐单抗对恶性胸腹腔积液效果的Meta分析

Hyperthermic perfusion chemotherapy combined with bevacizumab for treatment of malignant ascites or pleural effusion： a meta-analysis of efficacy

目的 对腔内热灌注化疗联合贝伐单抗治疗恶性胸腹腔积液的有效性进行Meta分析,为其进一步应用和研究提供依据.方法 计算机检索维普数据库、万方数据库、PubMed、中国知网数据库,收集腔内热灌注化疗联合贝伐单抗与单纯腔内热灌注化疗治疗恶性胸腹腔积液的临床对照试验,检索时限从各数据库建立到2018年1月.在严格依照纳入与排除标准下,两位研究者独立进行文献筛选、资料提取和质量评价工作,采用RevMan 5.3软件进行Meta分析.结果 共纳入4个临床对照试验,226例患者.Meta分析显示,贝伐单抗联合热灌注化疗组的临床有效率（OR=4.82,95％CI 2.45～ 9.49,P＜0.000 01）、恶性胸腹腔积液控制率（OR=4.06,95％CI 1.09～ 15.11,P＜ 0.05）、患者生命质量改善率（OR=6.79,95％CI3.53～13.08,P＜ 0.000 01）均优于单纯热灌注化疗组,差异均有统计学意义.结论 热灌注化疗联合贝伐单抗可以提高恶性胸腹腔积液患者的临床有效率、积液控制率和生命质量改善率.

Objective To make a meta-analysis of the effectiveness of hyperthermic perfusion chemotherapy （HPC） combined with bevacizumab for malignant ascites or malignant pleural effusion,and to provide the references for further practice and studies.Methods VIP,Wanfang data,PubMed and CNKI were searched from inception to January 2018.HPC combined with bevacizumab or HPC alone for malignant ascites or pleural effusion were collected for controlled clinical trial （CCT）.According to inclusion and exclusion criteria,two reviewers checked studies,extracted data and assessed quality of the included studies.RevMan 5.3 software was used to make a meta-analysis.Results A total of 4 CCT involved 226 patients.Meta-analysis showed that compared with the HPC alone,HPC combined with bevacizumab had a higher rate in clinical efficiency （OR =4.82,95 % CI 2.45-9.49,P 〈 0.000 01）,malignant ascites or pleural effusion control rate （OR =4.06,95 % CI 1.09-15.11,P 〈 0.05）,quality of life improvement rate （OR =6.79,95 % CI 3.53-13.08,P 〈 0.000 01）,and the difference was statistically significant.Conclusion HPC combined with bevacizumab can improve the clinical effective rate,effusion control rate and quality of life improvement rate of the patients with malignant ascites or pleural effusion.