Background
Methods
Searching and identification of studies
Inclusion criteria for selecting studies
Exclusion criteria for selecting studies
Extraction of study variables
Screening of clinical intervention
Efficacy evaluation criteria for treating MPE
Quality evaluation of included studies
Statistical ideas
Results
A total of 12 studies are included in this meta-analysis
The baseline clinical feature of included studies shows a good consistency
Study | N | Male | Female | Age (Years) | Histology of Lung cancer | Quality of Life | End point | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
LAC | LSCC | SCLC | LCLC | ADSC | Other | |||||||
Yuquan L 2005 [25] | 36 | 25 | 11 | – | 29 | 7 | 0 | 0 | 0 | KPS ≥ 50 | ORR, DCR, AEs | |
Do W 2005 [20] | 62 | – | – | 24–81 | – | – | – | – | – | – | KPS ≥ 50 | ORR, DCR, AEs |
Yanhao W 2006 [13] | 56 | 37 | 19 | 24–80 | 40 | 5 | 6 | 0 | 3 | 2 | KPS ≥ 50 | ORR, DCR, AEs |
Zhijun W 2007 [26] | 84 | 61 | 23 | 36–73 | 56 | 16 | 0 | 0 | 12 | 0 | ECOG≤2 | ORR, DCR, AEs |
Shimeng F 2010 [22] | 73 | 43 | 30 | 38–76 | 51 | 11 | 11 | 0 | 0 | 0 | KPS ≥ 60 | ORR, DCR, AEs |
Hua Z 2010 [9] | 58 | 31 | 27 | 39–81 | 47 | 10 | 0 | 0 | 1 | 0 | KPS ≥ 60 | ORR, DCR, AEs |
Xiqiang W 2010 [24] | 54 | – | – | 36–72 | 32 | 19 | 0 | 3 | 0 | 0 | ECOG≤2 | ORR, DCR, AEs |
Haiyan C 2015 [10] | 53 | 25 | 28 | 40–81 | 36 | 13 | −0 | 0 | 0 | 4 | KPS ≥ 60 | ORR, DCR, AEs |
Jin L 2015 [12] | 55 | – | – | 62.5 | 55 | 0 | 0 | 0 | 0 | 0 | KPS ≥ 60 | ORR, DCR, SI, AEs |
Tao H 2016 [23] | 60 | 38 | 22 | 41–78 | 60 | – | ORR, DCR, AEs | |||||
Chun W 2016 [19] | 64 | 35 | 29 | 65–89 | 37 | 27 | 0 | 0 | 0 | 0 | – | ORR, DCR, AEs |
Hua Z 2017 [21] | 39 | 19 | 20 | 61–88 | 32 | 7 | 0 | 0 | 0 | 0 | KPS ≥ 50 | ORR, DCR, AEs |
Quality assessment of included studies
Studies | Region | Sequence generation | Allocation concealment | Blind | Outcome data | Selective outcome reporting | Other sources of bias | ITT | Risk of bias |
---|---|---|---|---|---|---|---|---|---|
Yuquan L 2005 [25] | Single center | – | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Do W 2005 [20] | Single center | Random number table (SPSS) | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Yanhao W 2006 [13] | Single center | Random number table (SPSS) | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Zhijun W [26] | Single center | – | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Shimeng F 2010 [22] | Single center | Random number table (SPSS) | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Hua Z 2010 [9] | Single center | Random number table (SPSS) | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Xiqiang W 2010 [24] | Single center | – | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Haiyan C 2015 [10] | Single center | Random number table (SAS) | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Jin L 2015 [12] | Single center | – | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
Tao H 2016 [23] | Single center | Random number table (SPSS) | Insufficient | Clear | Yes | No | Unclear | Yes | Low risk of bias |
Chun W 2016 [19] | Single center | Random number table (SPSS) | Insufficient | Clear | Yes | No | Unclear | Yes | Low risk of bias |
Hua Z 2017 [21] | Single center | Random number table (SPSS) | Insufficient | Unclear | Yes | No | Unclear | Yes | Unclear risk of bias |
The included studies display a good comparability
Study | Trial group (N) | Control Group (N) | Interventions (Groups) | Treatment cycle | Termination of treatment | |
---|---|---|---|---|---|---|
rmhTNF+cisplatin | Cisplatin alone | |||||
Yuquan L 2005 [25] | 18 | 18 | rmhTNF 10 million units+NS 40 mL Cisplatin 60 mg + NS 50 mL | Cisplatin 60 mg + NS 50 mL | 1/week | > 2 cycles, or pleural effusion disappeared |
Do W 2005 [20] | 31 | 31 | rmhTNF 15 million units+NS 20 mL Cisplatin 30 mg/m2 + NS 20 mL | Cisplatin 40 mg/m2 + NS 20 mL | 2–3/week | > 2 cycles, or pleural effusion disappeared |
Yanhao W 2006 [13] | 28 | 28 | rmhTNF 15 million units+NS 40 mL Cisplatin 60 mg + NS 50 mL | Cisplatin 60 mg + NS 50 mL | 1/week | > 2 cycles, or pleural effusion disappeared |
Zhijun W [26] | 53 | 31 | rmhTNF 1.5 million units+NS 40 mL Cisplatin 60 mg + NS 50 mL | Cisplatin 60 mg + NS 50 mL | 1/week | > 2 cycles, or pleural effusion disappeared |
Shimeng F 2010 [22] | 43 | 30 | rmhTNF 15 million units+NS 20 mL Cisplatin 30 mg/m2 + NS 20 mL | Cisplatin 40 mg/m2 + NS 20 mL | 2–3/week | > 2 cycles, or pleural effusion disappeared |
Hua Z 2010 [9] | 34 | 24 | rmhTNF 1 million units+NS 20 mL Cisplatin 40 mg/m2 + NS 20 mL | Cisplatin 40 mg/m2 + NS 20 mL | 1/week | > 2 cycles, or pleural effusion disappeared |
Xiqiang W 2010 [24] | 23 | 31 | rmhTNF 2 million units+NS 40 mL Cisplatin 40 mg + NS 40 mL | Cisplatin 40 mg + NS 40 mL | 1/week | > 2 cycles, or pleural effusion disappeared |
Haiyan C 2015 [10] | 26 | 27 | rmhTNF 5 million units+NS 25 mL Cisplatin 40-60 mg + NS 50 mL | Cisplatin 40-60 mg + NS 25 mL | 1/week | > 2 cycles, or pleural effusion disappeared |
Jin L 2015 [12] | 26 | 29 | rmhTNF 15 × 106 units+NS 20 mL Cisplatin 40 mg/m2 + NS 20 mL | Cisplatin 40 mg/m2 + NS 20 mL | 1/week | > 4 cycles, or pleural effusion disappeared |
Tao H 2016 [23] | 30 | 30 | rmhTNF 2 × 106 units+NS 20 mL Cisplatin 30 mg/m2 + NS 20 mL | Cisplatin 30 mg/m2 + NS 20 mL | 1/week | > 4 cycles, or pleural effusion disappeared |
Chun W 2016 [19] | 32 | 32 | rmhTNF 3 million units+NS 60 mL Cisplatin 40 mg + NS 60 mL | Cisplatin 40 mg + NS 60 mL | 1/week | > 2 cycles, or pleural effusion disappeared |
Hua Z 2017 [21] | 21 | 18 | rmhTNF 1 million units+NS 20 mL Cisplatin 40 mg/m2 + NS 20 mL | Cisplatin 40 mg/m2 + NS 20 mL | 1/week | > 4 cycles, or pleural effusion disappeared |
Heterogeneity analysis of included studies does not show a statistical significance
Thoracic perfusion of rmhTNF combined with cisplatin shows a higher ORR and improves the QOL of MPE patients compared with cisplatin alone
Study | Study design (N) | Intravenous chemotherapy simultaneously | Pleural perfusion (N) | Efficacy of therapy | Improvement of SI (N,%) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Group 1 | Group 2 | Group 1 | Group 2 | ||||||||||||
Group 1 | Group 2 | CR | PR | SD | PD | CR | PR | SD | PD | Group 1 | Group 2 | ||||
Yuquan L 2005 [25] | 18 | 18 | No | rmhTNF+cisplatin | Cisplatin | 5 | 11 | 3 | 2 | 10 | 6 | – | – | ||
Do W 2005 [20] | 31 | 31 | No | rmhTNF+cisplatin | Cisplatin | 14 | 13 | 4 | 10 | 10 | 11 | – | – | ||
Yanhao W 2006 [13] | 28 | 28 | No | rmhTNF+cisplatin | Cisplatin | 10 | 13 | 5 | 5 | 9 | 14 | – | – | ||
Zhijun W [26] | 53 | 31 | No | rmhTNF+cisplatin | Cisplatin | 31 | 18 | 4 | 9 | 16 | 6 | – | – | ||
Shimeng F 2010 [22] | 43 | 30 | No | rmhTNF+cisplatin | Cisplatin | 27 | 12 | 4 | 9 | 8 | 13 | 40/43 | 17/30 | ||
Hua Z 2010 [9] | 34 | 24 | TP | rmhTNF+cisplatin | Cisplatin | 28 | 3 | 3 | 18 | 2 | 4 | – | – | ||
Xiqiang W 2010 [24] | 23 | 31 | No | rmhTNF+cisplatin | Cisplatin | 2 | 18 | 3 | 1 | 17 | 13 | – | – | ||
Haiyan C 2015 [10] | 26 | 27 | No | rmhTNF+cisplatin | Cisplatin | 6 | 19 | 1 | 4 | 15 | 8 | – | – | ||
Jin L 2015 [12] | 26 | 29 | No | rmhTNF+cisplatin | Cisplatin | 16 | 8 | 1 | 1 | 7 | 9 | 8 | 5 | 24/26 | 16/29 |
Tao H 2016 [23] | 30 | 30 | No | rmhTNF+cisplatin | Cisplatin | 14 | 12 | 4 | 8 | 8 | 14 | – | – | ||
Chun W 2016 [19] | 32 | 32 | No | rmhTNF+cisplatin | Cisplatin | 16 | 8 | 8 | 7 | 6 | 19 | – | – | ||
Hua Z 2017 [21] | 21 | 18 | No | rmhTNF+cisplatin | Cisplatin | 2 | 13 | 6 | 1 | 9 | 8 | – | – |
Participation of rmhTNF increases the incidence rate of fever but does not affect the incidence of chest pain
Study | Fever (N) | Chest pain (N) | Myelosuppression (N) | Digestive reaction (N) | Liver and kidney dysfunction (N) | |||||
---|---|---|---|---|---|---|---|---|---|---|
Group 1 | Group 2 | Group 1 | Group 2 | Group 1 | Group 2 | Group 1 | Group 2 | Group 1 | Group 2 | |
Do W 2005 [20] | 21/30 | 1/30 | 13/30 | 18/30 | 11/30 | 10/30 | 17/30 | 14/30 | 1/30 | 1/30 |
Yanhao W 2006 [13] | 3/28 | 4/28 | 4/28 | 2/28 | 0/28 | 2/28 | 0/28 | 16/28 | – | – |
Zhijun W [26] | 5/53 | 2/31 | 5/53 | 2/31 | 5/53 | 3/31 | 4/53 | 4/31 | 2/53 | 2/31 |
Shimeng F 2010 [22] | 13/43 | 3/30 | 8/43 | 18/30 | 2/43 | 5/30 | 3/43 | 15/30 | – | – |
Hua Z 2010 [9] | 20/34 | 0/24 | 22/34 | 20/24 | – | – | 15/34 | 14/24 | – | – |
Xiqiang W 2010 [24] | 5/23 | 0/31 | – | – | 8/23 | 9/31 | 16/23 | 21/31 | 2/23 | 2/31 |
Haiyan C 2015 [10] | 2/26 | 1/27 | 3/26 | 4/27 | 2/26 | 3/27 | 4/26 | 2/27 | – | – |
Jin L 2015 [12] | 14/26 | 3/29 | 6/26 | 6/29 | 1/26 | 1/29 | 4/26 | 4/29 | 2/26 | 1/29 |
Tao H 2016 [23] | 14/30 | 5/30 | 13/30 | 10/30 | – | – | 7/30 | 9/30 | – | – |
Chun W 2016 [19] | 4/32 | 0/32 | – | – | – | – | – | – | – | – |
Hua Z 2017 [21] | 14/21 | 0/18 | 12/21 | 13/18 | – | – | 12/21 | 11/18 | – | – |
P < 0.05 | P > 0.05 | P > 0.05 | P > 0.05 | P > 0.05 |