Abstract
Objective To systematically review the efficacy and safety of intrathoracic chemotherapy combined with thermotherapy (ITCT) for malignant pleural effusion (MPE).Methods From August 2015 to January 2016,a computerbased retrieval was performed in foreign databases such as Cochrane Library,PubMed,EMBase,Web of Science and Chinese ones such as CBM,CNKI,VIP and Wanfang,and supplementary retrieval was also performed with other sources.All relevant randomized controlled trials (RCTs) were collected to compare ITCT (ITCT group) and monotherapy of intrathoracic chemotherapy (ITC group).We extracted the relevant information from the literatures,including the first author,published time,sample size,age,Karnofsky performance status,chemotherapy regimens and outcome indicators.Then we assessed the methodologic quality of included studies.Results A total of 23 literatures were included,comprising 1 647 patients,including 819 in the ITCT group and 828 in the ITC group.Five studies reported random methods,yet none of the included studies mentioned the concealment of allocation and blinding.The baseline comparability of the two groups had fine balance.One study had loss of follow-up.There was no selective outcome reporting in any of the included studies.Total effective rate [OR =3.72,95％ CI (2.92,4.74)],complete remission rate [OR =2.24,95％ CI (1.81,2.78)] and improving rate of life quality [OR =3.66,95％ CI (2.64,5.07)] of ITCT group were superior to those of ITC group and there were all significant difference (P ＜ 0.05).There were no significant difference between the two groups on the incidence of nausea and vomiting [OR =0.80,95％CI (0.60,1.06)],leukocytopenia [OR=0.81,95％CI (0.60,1.10)],fever [OR =0.98,95％CI (0.69,1.40)],hepatic lesion [OR =0.45,95％ CI (0.11,1.81)],pneumothorax [OR =0.41,95％ CI (0.06,2.91)] and skin scald [OR =5.33,95％ CI (0.91,31.14)].The incidence of stethalgia in ITCT group was lower than ITC group [OR =0.34,95％CI (0.16,0.74)],the incidence of subcutaneous fat scleroma in ITCT group was higher than ITC group [OR =6.27,95％CI (1.08,36.27)],and there were all significant difference (P＜0.05).Conclusion Compared with ITC,ITCT can significant improve short-term curative effect and life quality of patients with MPE;additionally,it is safe and feasible.But its long-term survival rate and security still needs to be further verified by more large sample and high quality studies.关键词
胸腔积液,恶性/化学疗法,肿瘤/热疗/疗效/Meta分析Key words
Pleural effusion, malignant/Chemotherapy, cancer/Thermotherapy/Effectiveness/Meta-analysis分类
医药卫生
