贝伐单抗联合化疗药物胸腔灌注治疗肺癌合并恶性胸腔积液的Meta分析  

Efficacy and safety of intrapleural combination therapy with bevacizumab and chemotherapeutic agents for lung cancer-mediated malignant pleural effusion:a meta-analysis

作　　者：邓见青 苏清清 张少伟[1] 初向阳[1] Deng Jianqing Su Qingqing Zhang Shaozvei Chu Xiangyang(Department of Thoracic Surgery Department of Nursing, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院胸外科,北京100853 [2]解放军总医院护理部,北京100853

出　　处：《中华胸部外科电子杂志》2017年第2期112-119,共8页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

摘　　要：目的采用Meta分析的方法评价贝伐单抗联合化疗药物胸腔灌注治疗肺癌合并恶性胸腔积液(MPE)的疗效及安全性。方法检索The Cochrane Library、PubMed、Embase、Web of Science数据库以及中国生物医学文献数据库、中国期刊全文数据库、维普、万方数据库,自2001年1月1日贝伐单抗有文献报道以来至2017年2月30日的文献。纳入贝伐单抗联合化疗药胸腔灌注治疗肺癌合并MPE的随机对照试验(RCT)。以总有效率、主要不良反应为评价指标,采用相对危险度(RR)为效应量,使用Review Manager5.3和Stata12.0软件进行Meta分析。结果最终纳入8项RCT共510例肺癌合并MPE患者。Meta分析结果显示,联用贝伐单抗与化疗药物胸腔灌注可提高肺癌合并MPE治疗有效率[RR=1.43,95%可信区间(95%CI)=1.27~1.62,P<0.001];两组患者治疗不良反应差异均无统计意义(P>0.05)。结论贝伐单抗联合化疗药物胸腔灌注治疗肺癌合并MPE比单用化疗药物胸腔灌注治疗效果更好,且该治疗方案没有增加不良反应。Objective To systematically review the efficacy and safety of intrapleural injection of Bevacizumab combined with chemotherapeutic agents in treatment of lung cancer with malignant pleural effusion. Methods Databases including PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials （RCTs） about Bevacizumab combined with chemotherapeutic agents for lung cancer-mediated malignant pleural effusion from 2000 to February 2017. Overall response rates, main adverse effects incidence, relative risk（RR） were calculated. Then meta-analysis was performed by RevMan 5.3 and stata 12. 0 software. Results A total of 8 RCTs involving 510 patients were finally included. The results of Meta analysis showed that： the overall response rate in the Bevacizumab combined with chemotherapeutic agents group were higher than that of the conventional chemotherapeutic agents alone group （RR = 1 .43, 9S % CI 1. 27 to 1, 62, P〈 0. 001;）. However, there were no significant differences between two groups in incidence of main adverse effects （_ P〉0, 05）, Conclusions Compared with chemotheraputic agents, intrapleural injection of Bevacizumab combined with chemotherapeutic agents can improve the overall response rate without increasing incidence of main adverse reaction.

关 键 词：贝伐单抗 肺癌 恶性胸腔积液 META分析 随机对照试验 

分 类 号：R734.2[医药卫生—肿瘤]