贝伐珠单抗联合顺铂胸腔灌注治疗肺癌恶性胸腔积液meta分析  

Meta-analysis of Bevacizumab combined with Cisplatin in the treatment of malignant pleural effusion of lung cancer

作　　者：王博 刘佳佳 万海玉 张小艳 郑绘霞[3] WANG Bo;LIU Jiajia;WAN Haiyu;ZHANG Xiaoyan;ZHENG Huixia(The First Clinical Medical College,Shanxi Medical University,Shanxi Province,Taiyuan 030000,China;Department of Oncology,Shanxi Hospital of Traditional Chinese Medicine,Shanxi Province,Taiyuan 030000,China;Department of Pathology,the First Hospital of Shanxi Medical University,Shanxi Province,Taiyuan 030000,China)

机构地区：[1]山西医科大学第一临床医学院,山西太原030000 [2]山西省中医院肿瘤科,山西太原030000 [3]山西医科大学第一医院病理科,山西太原030000

出　　处：《中国医药导报》2022年第17期108-114,共7页China Medical Herald

基　　金：山西省科协健康科普课题项目(晋科协发[2020]15号)。

摘　　要：目的 系统客观评价对于贝伐珠单抗联合顺铂胸腔灌注治疗肺癌恶性胸腔积液的临床效果。方法 计算机检索中国期刊全文数据库、万方数据库、维普网、中国生物医学文献服务系统及PubMed、Embase、Central、Medline外文数据库。检索日期为建库至2021年8月。检索贝伐珠单抗联合顺铂治疗肺癌恶性胸腔积液的临床随机对照试验,由两名系统评价员分别进行文献资料的遴选、提炼文献中的数据、评价文献质量,数据剖析运用RevMan 5.3软件。结果 共17项研究纳入,患者共1028例。meta分析结果显示:试验组临床疗效(OR=4.02,95%CI:2.97~5.43,P <0.000 01)优于试验组,胸腔积液血管内皮生长因子水平(MD=53.24,95%CI:-55.46~-51.03,P <0.000 01)高于对照组,差异有统计学意义;对照组消化道不良反应(OR=0.64,95%CI:0.43~0.96,P=0.03)低于对照组,差异有统计学意义;两组血清癌胚抗原水平、总体不良反应率、骨髓抑制、肝肾功能损伤比较,差异无统计学意义(P> 0.05)。结论 贝伐珠单抗联合顺铂胸腔灌注治疗肺癌恶性胸腔积液的临床效果更优。由于本项研究入组临床文献质量评价不高,故需要临床开展更多缜密、详尽的高质量、随机双盲多中心临床对照试验以更有力的论证其治疗肺癌恶性胸腔积液的临床效果。Objective To evaluate the clinical efficacy of Bevacizumab combined with Cisplatin in the treatment of malignant pleural effusion of lung cancer. Methods The clinical data were collected from Chinese Journal full-text Database, Wanfang Data, VIP, Chinese Biomedical Literature Service system, PubMed, Embase, Central and Medline from the establishment of the database to August 2021. Two systematic reviewers searched the clinical randomized controlled trial of Bevacizumab combined with Cisplatin in the treatment of malignant pleural effusion of lung cancer, and then screened the literatures, extracted the data in the literature, and evaluated the quality of the literatures. The data were analyzed by Revman 5.3 software. Results A total of 17 studies were included, with a total of 1028 patients. The results of meta-analysis showed that the clinical efficacy(OR = 4.02, 95%CI:2.97 to 5.43, P < 0.000 01) of experimental group was better than the control group, vascular endothelial growth permeability factor level in pleural effusion(MD =53.24, 95%CI:-55.46 to-51.03, P < 0.000 01) in the experimental group were significantly higher than those in the control group, the difference was statistically significant. The gastrointestinal adverse reactions in the control group(OR = 0.64, 95%CI: 0.43 to 0.96, P = 0.03) were significantly higher than those in the experimental group, the difference was statistically significant. There was no significant difference in serum carcinoembryonic antigen level, overall adverse reactions, bone marrow suppression and liver and kidney function injury between the two groups(P > 0.05).Conclusion Bevacizumab combined with Cisplatin pleural perfusion is more effective in the treatment of malignant pleural effusion of lung cancer. As the evaluation of the clinical literature quality of this study is not high,it is necessary to carry out more meticulous, detailed,high-quality, and randomized double-blind and multicenter clinical controlled trials to more effectively demonstrate its clinical efficac

关 键 词：META分析 贝伐珠单抗 肺癌 恶性胸腔积液 胸腔灌注 

分 类 号：R273[医药卫生—中西医结合]