重组人血管内皮抑素联合顺铂治疗恶性胸腔积液的Meta分析

目的 系统评价重组人血管内皮抑素(Endostar)联合顺铂与单药顺铂胸腔内注射治疗恶性胸腔积液(MPE)的疗效及安全性.方法 搜索Pubmed、Embase、CBM、CNKI、万方及维普数据库系统,检索关于重组人血管内皮抑素联合顺铂与单药顺铂治疗MPE的随机对照试验(RCT).应用STATA 12.0软件对数据进行Meta分析.结果 总共纳入17篇RCT,总计1105例患者.Meta分析结果显示:重组人血管内皮抑素联合顺铂(联合组)的胸腔积液缓解率高于单药顺铂(观察组)(RR=1.623,95%CI=1.472~1.789;Z=9.71,P=0.000),联合组的KPS评分改善率高于观察组(RR=1.592,95%CI=1.422~1.782;Z=8.09,P=0.000).在消化道不良反应方面,联合组发生率高于观察组(RR=1.204,95%CI=1.003~1.447;Z=1.99,P=0.047).而肝肾毒性、骨髓抑制、发热、疲乏等不良反应的发生率两组比较差异无统计学意义(P>0.05).结论 现阶段研究结果证明,重组人血管内皮抑素联合顺铂治疗MPE的疗效优于单药顺铂,不良反应较轻,安全性好,期待纳入更多高质量研究进一步分析.

Efficacy and Safety of Recombinant Human Endostatin Combined with Cisplatin for Malignant Pleural Effusion:a Meta-analysis

Objective To assess the efficacy and safety of recombinant human endostatin ( Endostar ) combined with cis-platin for malignant pleural effusion by conducting a meta-analysis.Methods A comprehensive collection of randomized con-trolled trials( RCTs) about Endostar combined with cisplatin versus single cisplatin in the treatment of malignant pleural effusion was retrieved from Pubmed,Embase,CBM,CNKI,Wanfang and VIP databases .Meta-analysis was conducted by STATA 12.0 soft-ware.Results 17 RCTs involving 1105 patients were identified in the study .The meta-analysis results showed that:Endostar combined with cisplatin ( combined group ) had a higher hydrothorax total remission rate than single cisplatin ( observation group ) (RR=1.623,95%CI=1.472~1.789;Z=9.71,P=0.000);The KPS score in the combined group was better than that of the observation group(RR=1.592,95%CI=1.422~1.782;Z=8.09,P=0.000);The incidence rate of gastrointestinal side effects in the combined group was higher than that of the observation group (RR=1.204,95%CI=1.003 ~1.447;Z=1.99,P=0.047);There was no significant difference in adverse reactions of liver and kidney toxicities ,marrow suppression,heating and fa-tigue between the 2 groups(P>0.05).Conclusion The current study shows that,Endostar combined with cisplatin for malig-nant pleural effusion is superior to single cisplatin therapy .The side reaction is mild ,and the safety is identified .More high quality studies are expected to be further analyzed .