Du 2013.

Methods	Single centre RCT of intrapleural cisplatin +/‐ bevacizumab in MPE due to non‐small cell lung cancer (NSCLC) (China)
Participants	Inclusion: Advanced NSCLC; large uni‐ or bilateral pleural effusion; positive pleural fluid cytology; no intrapleural therapy in previous month; Karnofsky performance score > 60%; age > 18; predicted survival > 3 months; no major organ disfunction; no previous chemotherapy in previous six weeks Exclusion: squamous cell carcinoma; allergy to biological agents; no detectable lesions; uncontrolled central nervous system metastasis; pregnancy or breastfeeding; infected wound; refractory psychiatric illness 72 participants randomised
Interventions	Participants underwent pleural fluid drainage by thoracentesis. Treatment given intrapleurally. Rest for two hours. Then rotate every 15 mins. Given every two weeks for 3 cycles Cisplatin: 30 mg cisplatin intrapleurally Cisplatin and bevacizumab: 30 mg cisplatin and 300 mg bevacizumab intrapleurally
Outcomes	Treatment response ('Complete remission (CR)' = accumulated fluid disappeared and stable for at least four weeks; 'Partial remission (PR)' = > 50% of the accumulated fluid had disappeared, symptoms had improved and the remaining fluid had not increased for at least four weeks; 'Remission not obvious (NC)' = < 50% of the accumulated fluid had disappeared; 'Progression (PD)' = accumulated fluid had increased). Treatment success defined as CR + PR Progression‐free survival Overall survival Adverse reactions Quality of life (QOL) Pleural fluid VEGF levels
Notes	People with trapped lung eligible for trial involvement Pleurodesis defined clinically and using radiology Not included in network meta‐analysis
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Methods not stated and no response from study authors to clarify
Allocation concealment (selection bias)	Unclear risk	Methods not stated and no response from study authors to clarify
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not stated if blinded and no response from study authors to clarify
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not stated if anyone was blinded. If not blinded, QOL, performance status, side effects and symptom recurrence could be biased by lack of blinding
Incomplete outcome data (attrition bias) All outcomes	Low risk	Missing data accounted for. ITT analysis
Selective reporting (reporting bias)	Low risk	All outcomes reported on
Other bias	Low risk	No other biases identified