Efficacy and safety of injecting endostar combined with platinum complexes into pleural cavity for treatment of malignant pleural effusion: a meta-analysis review

Abstract

Objective To investigate the efficacy and safety of patients with malignant pleural effusion treated with injecting endostar combined with platinum complexes into pleural cavity. Methods Cochrane systematic review methods were used in the data selection, and data were selected from the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang, and VIP database to get all clinical controlled trials. The retrieval time was August 2014. The objects of these randomized controlled trials were malignant pleural effusion patients. Endostar combination with platinum complexes was used for the experimental group. Platinum complexes alone were used for the control group. The efficacy and adverse effects of two groups were compared. The quality of included trials was evaluated by two reviewers independently. The software RevMan 5.3 was used for meta-analyses. Results Nine trials with 488 patients were included according to the including criterion. All trials were randomized controlled trials, one of them had B level in quality and eight had C level. Meta analysis results were as follows: there was significant difference in overall effective rate (OR=3.52, 95% CI=2.37~5.22), Karnofsky (KPS) score changes rate (OR=2.64, 95% CI= 1.67~4.19), between endostar combination with platinum complexes and platinum complexes alone group. The incidences of severe leucopenia (OR=1.0, 95% CI=0.62~1.61) and nausea and vomiting (OR=0.77, 95% CI=0.43~1.38) were similar in the endostar combination with platinum complexes group compared to those in the platinum complexes alone group. Conclusions In the treatment of malignant pleural effusion, injecting endostar in combination with platinum complexes into pleural cavity improves the effective rate without obviously raised side effects. Owing to the small sample size and poor quality of included trials, more well-designed double-blinded randomized controlled trials should be performed. Key words: Endostatins/AD; Platinum compounds/AD; Pleural effusion, malignant/DT; Evaluation studies