Xu Yan, Cui Yingying, Jiang Liming, Yu Yinan, Si Wei, Zhu Xiaohua
Department of Oncology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
Department of Surgery, Yuyao Hospital of Traditional Chinese Medicine, Yuyao, Zhejiang, China.
BMJ Open. 2024 Dec 20;14(12):e080703. doi: 10.1136/bmjopen-2023-080703.
Different intrathoracic perfusion therapeutic regimens are available for non-small cell lung cancer with malignant pleural effusion (MPE). Antiangiogenic agents are often used to control MPE, and the results are satisfactory. Here, we performed a network meta-analysis to reveal optimal combinations of antiangiogenic agents and chemical agents and assess their effectiveness and safety.
Systematic review and network meta-analysis.
PubMed/Medline, Embase, Cochrane, Web of Science, Wanfang, VIP Database and Chinese National Knowledge Infrastructure were searched from inception to May 2023. Eligible studies were randomised controlled trials that reported on curative effect of MPE.
The Cochrane Collaboration tool was used to assess risk of bias. The consistency was evaluated by examining the agreement between direct and indirect effects. Network meta-analysis was performed and the ranking probabilities of being at each possible rank for each intervention were estimated. Comparison-adjusted funnel plots were obtained to assess publication bias.
A total of 46 studies were included in the analysis. Among them, we included a total of seven interventions. A total of 3026 patients participated in this analysis. According to the results of the network meta-analysis, some antiangiogenic agents combined with chemotherapy regimens improved objective response rate (ORR) and disease control rate (DCR) and quality of life (QOL). The rank probabilities suggested that in terms of ORR, DCR and QOL, Endostar plus lobaplatin was the first-ranked intervention.
Administration of antiangiogenic agents plus chemical agents significantly improved the clinical response and QOL. In addition, Endostar plus lobaplatin was the most effective combination.
CRD42021284786.
对于伴有恶性胸腔积液（MPE）的非小细胞肺癌，有不同的胸腔内灌注治疗方案。抗血管生成药物常被用于控制MPE，且效果令人满意。在此，我们进行了一项网状Meta分析，以揭示抗血管生成药物与化疗药物的最佳组合，并评估其有效性和安全性。
系统评价和网状Meta分析。
从数据库建立至2023年5月，检索了PubMed/Medline、Embase、Cochrane、Web of Science、万方数据库、维普数据库和中国知网。纳入的合格研究为报告了MPE治疗效果的随机对照试验。
采用Cochrane协作工具评估偏倚风险。通过检查直接效应和间接效应之间的一致性来评估一致性。进行网状Meta分析，并估计每种干预处于每个可能排名的概率。获得比较调整漏斗图以评估发表偏倚。
分析共纳入46项研究。其中共包括7种干预措施。共有3026例患者参与了该分析。根据网状Meta分析结果，一些抗血管生成药物联合化疗方案提高了客观缓解率（ORR）、疾病控制率（DCR）和生活质量（QOL）。排名概率表明，在ORR、DCR和QOL方面，恩度联合洛铂是排名第一的干预措施。
抗血管生成药物联合化疗药物显著改善了临床反应和QOL。此外，恩度联合洛铂是最有效的组合。
PROSPERO注册号：CRD42021284786。
