重组人血管内皮抑素联合顺铂胸腔灌注治疗恶性胸腔积液近期疗效的Meta分析

摘要

目的 评价重组人血管内皮抑素联合顺铂胸腔灌注治疗恶性胸腔积液的有效性和安全性.方法 计算机检索Elsevier、Pubmed、Medline、Cochrane Library、中国知网、中国生物医学文献数据库和万方数据库,筛选有关重组人血管内皮抑素联合顺铂化疗治疗恶性胸腔积液的随机对照试验,检索年限为从建库至2015年12月.使用RevMan 5.3版统计软件对数据进行Meta分析,计算相对危险度(RR)及95%可信区间(CI),采用Stata12.0版软件进行Egger检验.结果 纳入20个随机对照试验,患者共1 330例,单纯顺铂化疗组(对照组)665例,重组人血管内皮抑素联合顺铂化疗组(治疗组)665例.Meta分析结果显示,与对照组比较,治疗组总有效率显著升高[73.53% vs 45.41%,RR=1.62,95%CI(1.47,1.78),P<0.000 01],生活质量改善率显著升高[71.65% vs 46.94%,RR=1.52,95%CI(1.38,1.68),P<0.000 01],心脏不良反应发生率未见显著性升高(10.38% vs 5.77%,RR=1.73,95%CI(0.99,3.03),P=0.06].结论 重组人血管内皮抑素联合顺铂化疗治疗恶性胸腔积液的效果优于单独顺铂化疗.%Objective To evaluate the efficacy and safety of recombinant human endostatin (rh-endostatin) combined with cis-platinum for patients with malignant pleural effusions.Methods A computer-based online search was performed through Elsevier, PubMed, Medline, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database and Wanfang Database.According to the inclusion and exclusion criteria, the randomized controlled trials about short-term therapeutic effect of rh-endostatin combined with cis-platinum on malignant pleural effusions published until December 2015 were selected.Quality of the studies was assessed using modified Jadad scale.After data extraction, a Meta-analysis was performed by RevMan 5.3 software.Relative risk (RR) and its 95% confidence interval (CI) were calculated.The Egger test was performed by Stata 12.0 software.Results Fourteen eligible randomized controlled trials were included in this Meta-analysis involving 1 330 patients,665 in cis-platinum alone group(control group), and 665 in rh-endostatin combined with cis-platinum group(treatment group).The results showed that there were significant improvements in overall response rate (ORR) [73.53% vs 45.41%,RR=1.62,95%CI(1.47,1.78),P<0.000 01] and the rate of quality of life improvement [71.65% vs 46.94%,RR=1.52,95%CI(1.38,1.68),P<0.000 01] in the treatment group, as compared with those of the control group.Meanwhile, there were no statistically significant differences in the rate of cardio toxicity [10.38% vs 5.77%,RR=1.73,95%CI(0.99,3.03),P=0.06].Conclusion This Meta-analysis indicated that in comparison with cis-platinum alone, rh-endostatin combined with cis-platinum has a better therapeutic effect on malignant pleural effusions.