右江医学2026，Vol.54Issue(2)：172-180,9.DOI:10.3969/j.issn.1003-1383.2026.02.010
个体化与固定剂量贝伐珠单抗联合顺铂灌注治疗恶性胸腔积液的有效性和安全性的网状meta分析
Efficiency and safety of individualized versus fixed-dose bevacizumab combined with cisplatin perfusion therapy for malignant pleural effusion:a network meta-analysis
摘要
Abstract
Objective To compare the efficacy and safety of individualized(5 mg/kg)versus fixed-dose(300 mg)bev-acizumab combined with cisplatin intrapleural perfusion for non-small cell lung cancer(NSCLC)with malignant pleural effu-sion(MPE)using network meta-analysis,so as to provide evidence-based support for clinical precision medicine.Methods A systematic search was conducted across PubMed,Embase,Cochrane Library,Web of Science,SinoMed,CNKI,VIP,and WanFang Data databases to retrieve relevant randomized controlled trials(RCTs)published from January 2015 to Janu-ary 2025.Literature screening,data extraction,and bias risk assessment were independently conducted by two researchers,and network meta-analysis was performed by RevMan 5.3 and Stata 18.Results A total of 18 RCTs involving 1316 patients were included.Compared with cisplatin monotherapy,both personalized bevacizumab combined with cisplatin(OR=3.72,95％CI:2.70-5.13,P<0.001)and fixed-dose bevacizumab combined with cisplatin(OR=3.69,95％CI:2.30-5.95,P<0.001)significantly improved the overall response rate in the treatment of MPE,SUCR Aprobability analysis indi-cated that the individualized-dose regimen had superior efficacy.After treatment,the VEGF levels in pleural effusion signifi-cantly reduced in both groups.The WMD for the individualized group was-59.73,while the WMD for the fixed-dose group was-54.75.SUCRA analysis indicated that the individualized regimen had a more significant effect in reducing VEGF lev-els.In terms of safety,SUCRA probability analysis showed that the incidence of adverse reactions such as liver and kidney dysfunction,nausea and vomiting,hypertension,and bone marrow suppression was lower in the individualized dosing regi-men compared to the fixed-dose group.Conclusion Bevacizumab individualized regimen(5 mg/kg)combined with cispla-tin pleural perfusion demonstrates better effectiveness and safety profiles than the fixed-dose regimen(300 mg)for NSCLC with MPE,which potentially offers patients greater comprehensive clinical benefits.关键词
贝伐珠单抗/顺铂/非小细胞肺癌/恶性胸腔积液/网状meta分析/随机对照试验Key words
bevacizumab/cisplatin/non-small cell lung cancer(NSCLC)/malignant pleural effusion(MPE)/network meta-analysis/randomized controlled trial(RCT)分类
医药卫生引用本文复制引用
李延秋,邹银水,毕桢干..个体化与固定剂量贝伐珠单抗联合顺铂灌注治疗恶性胸腔积液的有效性和安全性的网状meta分析[J].右江医学,2026,54(2):172-180,9.基金项目
湖北省重大疑难疾病中西医临床协作项目—乳腺癌方向(鄂卫通[2023]52) （鄂卫通[2023]52）
湖北省自然科学基金项目—基于中医"治未病"思想的胃癌风险预警模型构建(2024AFD277) （2024AFD277）
