Liang Rong, Xie Hai-Ying, Lin Yan, Li Qian, Yuan Chun-Ling, Liu Zhi-Hui, Li Yong-Qiang
Department of First Chemotherapy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China E-mail :
Asian Pac J Cancer Prev. 2015;16(18):8637-44. doi: 10.7314/apjcp.2015.16.18.8637.
Malignant serous effusions (MSE) are one complication in patients with advanced cancer. Endostar is a new anti-tumor drug targeting vessels which exerts potent inhibition of neovascularization. This study aimed to systematically evaluate the efficacy and safety of intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions (MSE).
Randomized controlled trials (RCTs) on intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions were searched in the electronic data of PubMed, EMBASE, Web of Science, CNKI, VIP, CBM and WanFang. The quality of RCTs was evaluated by two independent researchers and a meta-analysis was performed using RevMan 5.3 software.
The total of 25 RCTs included in the meta-analysis covered 1,253 patients, and all literature quality was evaluated as "B" grade. The meta-analysis showed that Endostar combined with platinum had an advantage over platinum alone in terms of response rate of effusions (76% vs 48%, RR=1.63, 95%CI: 1.50-1.78, P<0.00001) and improvement rate in quality of life (69% vs 44%, RR=1.57, 95%CI: 1.42-1.74, P<0.00001). As for safety, there was no significant difference between the two groups in the incidences of nausea and vomiting (35% vs 34%, RR=1.01, 95%CI: 0.87-1.18, P=0.88), leucopenia (38% vs 38%, RR=1, 95%CI: 0.87-1.15, P=0.99), and renal impairment (18% vs 20%, RR=0.86, 95%CI: 0.43-1.74, P=0.68).
Endostar combined with platinum by intraperitoneal perfusion is effective for malignant serous effusions, and patient quality of life is significantly improved without the incidence of adverse reactions being obviously increased.
恶性浆液性胸腔积液（MSE）是晚期癌症患者的一种并发症。恩度是一种新型的抗血管生成抗肿瘤药物，具有强大的抑制新生血管生成的作用。本研究旨在系统评价恩度联合铂类化疗腹腔灌注治疗恶性浆液性胸腔积液的有效性和安全性。
检索PubMed、EMBASE、Web of Science、中国知网（CNKI）、维普资讯（VIP）、中国生物医学文献数据库（CBM）及万方数据库中的电子数据，查找关于恩度联合铂类化疗腹腔灌注治疗恶性浆液性胸腔积液的随机对照试验（RCT）。由两名独立研究人员对RCT的质量进行评价，并使用RevMan 5.3软件进行荟萃分析。
纳入荟萃分析的25项RCT共涉及1253例患者，所有文献质量均评为“B”级。荟萃分析结果显示，恩度联合铂类在胸腔积液缓解率（76%对48%，RR=1.63，95%CI：1.50-1.78，P<0.00001）及生活质量改善率（69%对44%，RR=1.57，95%CI：1.42-1.74，P<0.00001）方面优于单纯铂类。在安全性方面，两组在恶心呕吐发生率（35%对34%，RR=1.01，95%CI：0.87-1.18，P=0.88）、白细胞减少发生率（38%对38%，RR=1，95%CI：0.87-1.15，P=0.99）及肾功能损害发生率（18%对20%，RR=0.86，95%CI：0.43-1.74，P=0.68）上差异均无统计学意义。
恩度联合铂类腹腔灌注治疗恶性浆液性胸腔积液疗效显著，可明显提高患者生活质量，且未显著增加不良反应的发生率。
