The intrapleural administration with thymic peptides in malignant pleural effusion: A clustered systematic review and meta-analysis

被引:1
|
作者
Wang, Cheng-Qiong [1 ,2 ]
Shen, You-Shu [4 ]
Chen, Xiao-Fan [3 ]
Jiang, Hong [1 ,2 ]
Yang, Xue-Mei [1 ,2 ]
Fan, Teng-Yang [2 ]
Li, Shu-Guang [2 ]
Yang, Ping [4 ]
Zhan, Lin [5 ]
Chen, Rong [6 ]
Feng, Ji-Hong [7 ]
Xiao, Xue [1 ,2 ]
Xiao, Zheng [1 ,2 ]
机构
[1] Zunyi Med Coll, Affiliated Hosp, Evidence Based Med Ctr, MOE Virtual Res Ctr Evidence Based Med, Zunyi 563003, Guizhou, Peoples R China
[2] Zunyi Med Univ, Dept Gen Practice, Affiliated Hosp, Zunyi 563003, Guizhou, Peoples R China
[3] Jiangxi Univ Tradit Chinese Med, Evidence Based Med Res Ctr, Nanchang 330004, Jiangxi, Peoples R China
[4] Zunyi Med Univ, Dept Infect Dis, Affiliated Hosp, Zunyi 563003, Guizhou, Peoples R China
[5] Guizhou Univ, Guizhou Prov Peoples Hosp, Lab Res Ctr, Guiyang 550002, Guizhou, Peoples R China
[6] Anshun Peoples Hosp, Dept Infect Dis, Anshun 561000, Guizhou, Peoples R China
[7] Wenzhou Med Univ, Lishui Peoples Hosp, Dept Oncol, Affiliated Hosp 6, Lishui, Zhejiang, Peoples R China
关键词
Malignant pleural effusion (MPE); Thymic peptides (TPs); Intrapleural administration; Chemical agents; Clustered systematic review; Meta-analysis; MANAGEMENT; CANCER; BLEOMYCIN;
D O I
10.1016/j.intimp.2022.108688
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Thymic peptides (TPs) are often used to control malignant pleural effusion (MPE). So, we performed a clustered systematic review and meta-analysis to clarify the treatment regimens of TPs for MPE, demonstrate their clinical effectiveness and safety, and reveal the indications and optimal usage for a desired effectiveness. Materials and methods: We collected all trials of TPs for MPE from Chinese and English databases (from inception until May 2021). After evaluating their bias risk, we pooled the data from each regimen using the meta-analysis or descriptive analysis, and summarized the evidence quality using the Grading of Recommendation Assessment, Development and Evaluation approach (GRADE). Results: Thirty-four trials were clustered into TPs for MPE from lung cancer or miscellaneous tumors. The TPs combined with chemical agents were mainly used in MPE from lung cancer. All five regimens, only thymosin with oxaliplatin (L-OHP) significantly improved the complete response (CR) [2.40 (1.84 to 3.13)], quality of life [2.04 (1.20 to 3.48)], 0.5- and 1-year overall survival (OS) rate [5.75 (3.02 to 10.92) and 5.29, (1.71 to 16.36)]. It also up-regulated the T lymphocyte levels, and reduced the pleurodesis failure, disease progression and adverse events. In patients with moderate to large volume, Karnofsky Performance Status score >= 50 or anticipated survival time >= 3 months, the thymosin (300 mg/time, one time/week and lasting two to eight times) with oxaliplatin (100 mg/m(2)) achieved a desired response. Most results were moderate quality. Conclusions: The current evidences indicate that the TPs are important pleurodesis agents, which combination with chemical agents are mainly used in MPE from lung cancer. The thymosin with L-OHP is a main regimen, which shows a significant improvement in clinical responses, antitumor immunity, and with a reasonable security. The evidence also provides indications and optimal usage for achieving a desired effectiveness.
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页数:20
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