METHODS: PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Chinese Science and Technology Journal Full-text Database (VP-CSJFD), and Wanfang database were searched by computer from database establishment to January 17, 2024. Relevant randomized controlled articles with IPHC as the observational group and intrapleural perfusion chemotherapy (IPC) as the control group for MPE were included. Then, the methodological quality of the included articles was evaluated and statistically analyzed using Stata 16.0.
RESULTS: Sixteen trials with 647 patients receiving IPHC and 661 patients receiving IPC were included. The meta-analysis found that MPE patients in the IPHC group had a more significant objective response rate [RR = 1.31, 95%CI (1.23, 1.38), P < 0.05] and life quality improvement rate [RR = 2.88, 95%CI (1.95, 4.24), P < 0.05] than those in the IPC group. IPHC and IPC for MPE patients had similar incidence rates of asthenia, thrombocytopenia, hepatic impairment, and leukopenia.
CONCLUSIONS: Compared with IPC, IPHC has a higher objective response rate without significantly increasing adverse reactions. Therefore, IPHC is effective and safe. However, this study is limited by the quality of the literature. Therefore, more high-quality, multi-center, large-sample, rigorously designed randomized controlled clinical studies are still needed for verification and evaluation.
方法:PubMed,Embase,科克伦图书馆,中国国家知识基础设施(CNKI),中国生物医学文献数据库(CBM),VIP中国科技期刊全文数据库(VP-CSJFD),从数据库建立到2024年1月17日,对万方数据库进行了计算机搜索。纳入相关随机对照文章,以IPHC为观察组,胸膜腔内灌注化疗(IPC)为MPE对照组。然后,采用Stata16.0对纳入文献的方法学质量进行评价和统计学分析。
结果:纳入了16项试验,647例患者接受IPHC,661例患者接受IPC。meta分析发现,IPHC组MPE患者的客观缓解率更显著[RR=1.31,95CI(1.23,1.38),P<0.05和生活质量改善率[RR=2.88,95CI(1.95,4.24),P<0.05]优于IPC组。MPE患者的IPHC和IPC的虚弱发生率相似,血小板减少症,肝功能损害,和白细胞减少症.
结论:与IPC相比,IPHC具有较高的客观应答率,且无显著增加的不良反应。因此,IPHC是有效和安全的。然而,这项研究受到文献质量的限制。因此,更高质量,多中心,大样本,严格设计的随机对照临床研究仍需进行验证和评价.