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  • Recombinant human endostatin combined with platinum compounds for malignant pleural effusion: an overview of systematic reviews

    Objective To overview the systematic reviews of recombinant human endostatin combined with platinum compounds for malignant pleural effusion (MPE). Methods According to the inclusion and exclusion criteria and searching strategies, we screened the systematic reviews of recombinant human endostatin combined with platinum compounds for the treatment of MPE by searching the Embase, PubMed, Clinical Trials, Cochrane Library, China National Knowledge Infrastructure, CQVIP Database and Wanfang Database. The searching time was from January 1999 to December 2021. The methodological quality was evaluated using AMSTAR 2 tool, the report quality was evaluated using PRISMA statement, and the evidence quality of the outcome indicators was graded according to the GRADE system. Finally, RevMan 5.3 software was used to quantitatively merge and analyze the original research effect values of the main outcome indicators with low level of evidence. Results A total of 9 systematic reviews/meta-analyses involving 8 outcome indicators and totally 50 outcomes were included. The average PRISMA scale score was 22.28±1.37, with 6 reports being relatively complete and 3 reports having certain reporting defects. The overall methodological quality of the 9 systematic reviews was extremely low. Most of the 50 outcomes were graded as “low” (31 outcomes) or “intermediate” (18 outcomes) quality. The results of 9 systematic reviews all showed that the clinical efficacy of dual therapy was more satisfactory than that of platinum-based preparations in the treatment of MPE, and re-quantitative analysis also confirmed that there was no statistically significant difference in the incidence of adverse events between the two treatments (P>0.05). Conclusions Considering the existing evidence and the results of meta-analysis, the dual therapy composed of recombinant human endostatin and platinum compounds is more effective in the treatment of MPE, and there is no difference in the incidence of related adverse events. However, because of its poor methodological quality and the low level of evidence, the above conclusions can only provide a certain reference and need to be confirmed by further research.

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