Intrathoracic infusion therapy with Lentinan and chemical irritants for malignant pleural effusion: a systematic review and meta-analysis of 65 randomized controlled trials

•Meta-analysis involving 65 randomized controlled trials containing 4,080 patients.•Lentinan with DDP may be an optimal combination with chemical irritants.•The moderate to large, KPS score ≥50-60, AST ≥3m may be therapeutic threshold.•Treatment with 3-4mg/time, one time/week for 3-4 times may be optimal usage.•Lentinan may show a synergistic effect for DDP, and decrease its dosage.