Abstract:

Objective  To explore the therapeutic effect and safety of intrathoracic injection of bevacizumab combined with cisplatin on malignant pleural effusion (MPE) of patients with non-small cell lung cancer (NSCLC). Methods  A total of 54 NSCLC patients with MPE were randomly divided into the cisplatin group (control group, n=26) and bevacizumab combined with cisplatin group (combined treatment group, n=28) according to different treatment plans. Patients of the control group received intrathoracic injection of cisplatin of 75 mg/m² twice and each cycle was 21 d. Patients of the combined treatment group received intrathoracic injection of bevacizumab of 5 mg/kg twice and each cycle was 21 d, and the administration of cisplatin was the same as the control group. Patients of two groups all underwent systemic chemotherapy. The volume of pleural effusion and the level of vascular endothelial growth factor (VEGF) in pleural effusion were measured before each cycle. The therapeutic effect was evaluated according to control rates of pleural effusion and disease. The incidence of adverse reactions during the treatment was observed. Results  The control rates of pleural effusion of the combined treatment group and control group were 85.7% and 69.2% and the control rates of disease were 96.4% and 80.8% after treatment. The differences were statistically significant (P<0.05). The control rate of pleural effusion of the combined treatment group was significantly higher than that of the control group at each stage of treatment (P<0.05). The VEGF levels in pleural effusion of the combined treatment group and control group after treatment were lower than those before treatment and the reduction of pleural effusion of the combined treatment group was more remarkable (P<0.05). Compared with the control group, new or aggravating adverse reactions were not found in the combined treatment group. Conclusion  Intrathoracic injection of bevacizumab and cisplatin is an efficient and safe treatment method for NSCLC patients with malignant pleural effusion.

Key words: malignant pleural effusion, non-small cell lung cancer, bevacizumab, cisplatin