Guilin Medical University, Guilin, China.
Affiliated Hospital of Guilin Medical University, Guilin, China.
Medicine (Baltimore). 2022 Dec 30;101(52):e32207. doi: 10.1097/MD.0000000000032207.
Although there are new treatments for non-small cell lung cancer with malignant pleural effusion, these therapies are prone to recurrent pleural effusion and poor in efficacy. And recombinant human endostatin is a new type of anti-tumor angiogenesis drug independently developed in my country. It has the effect of inhibiting tumor angiogenesis, inhibiting tumor proliferation and differentiation, and effectively inhibiting the formation and recurrence of malignant pleural effusion. Therefore, this study is aim to systematically review the efficacy and safety of intrapleural injection of endostar combined with cisplatin in the treatment of non-small cell lung cancer (NSCLC) with malignant pleural effusion.
Databases including Cochrane Library, PubMed, CBM, Embase, CNKI, and WanFang Data were searched to collect randomized controlled trials about endostar combined with cisplatin for NSCLC with malignant pleural effusion from inception to April 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in included studies. Finally, the meta-analysis was made by using RevMan 5.4.1 software.
A total of 11 randomized controlled trials involving 814 patients were finally included. The results of the meta-analysis showed that: The overall response rate and the improvement rate of quality of life in the endostar combined with cisplatin group were higher than that of the cisplatin alone group (relative risk = 1.58, 95% confidence interval = 1.42-1.76, P < .00001; relative risk = 1.63, 95% confidence interval = 1.38-1.93, P < .00001, respectively). Meanwhile, there were no significant differences between the 2 groups in the incidence of gastrointestinal reaction, the incidence of leucopenia, the incidence of thrombocytopenia, and the incidence of hypodynamia (all P values > .05).
Compared with cisplatin, intrapleural injection of endostar combined with cisplatin could improve the overall response rate and the quality of life of NSCLC patients with malignant pleural effusion. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.
尽管有新的治疗方法用于治疗非小细胞肺癌合并恶性胸腔积液,但这些治疗方法容易导致胸腔积液复发,疗效不佳。而重组人血管内皮抑制素是我国自主研发的新型抗肿瘤血管生成药物,具有抑制肿瘤血管生成、抑制肿瘤增殖和分化、有效抑制恶性胸腔积液形成和复发的作用。因此,本研究旨在系统评价胸腔内注射恩度联合顺铂治疗非小细胞肺癌(NSCLC)合并恶性胸腔积液的疗效和安全性。
检索 Cochrane Library、PubMed、CBM、Embase、CNKI、万方数据等数据库,收集从建库至 2022 年 4 月恩度联合顺铂治疗 NSCLC 合并恶性胸腔积液的随机对照试验。由 2 位评价者独立筛选文献、提取资料并评价纳入研究的偏倚风险,最后采用 RevMan 5.4.1 软件进行 meta 分析。
最终纳入 11 项随机对照试验,共 814 例患者。meta 分析结果显示:恩度联合顺铂组的总缓解率和生活质量改善率均高于顺铂单药组[相对危险度(RR)=1.58,95%置信区间(CI)=1.421.76,P<0.00001;RR=1.63,95%CI=1.381.93,P<0.00001]。同时,2 组间胃肠道反应发生率、白细胞减少发生率、血小板减少发生率和乏力发生率的差异均无统计学意义(均 P 值>0.05)。
与顺铂相比,胸腔内注射恩度联合顺铂可提高 NSCLC 合并恶性胸腔积液患者的总缓解率和生活质量。但由于纳入研究的质量和数量有限,需要更多高质量的研究来验证上述结论。