[Mechanisms and Clinical Translation Advances of Physical Targeted Therapy 
for Malignant Pleural Effusion]

Malignant pleural effusion (MPE) is a common severe complication of advanced lung cancer and significantly worsens prognosis. Physical targeted therapies, represented by piezocatalytic therapy, sonodynamic therapy, photodynamic therapy, hyperthermic intrathoracic chemotherapy, radiofrequency ablation and thermosensitive in situ hydrogel drug delivery system, induce reactive oxygen species generation via light, ultrasound, or piezocatalytic energy, or achieve tumor killing through local hyperthermia and temperature-controlled drug release, offering new strategies for MPE. However, existing reviews mostly focus on single modalities, lacking systematic classification and suitability comparison based on the pleural microenvironment and respiratory mechanics. This review summarizes their mechanisms, biological effects, and translational status in the context of pleural anatomy and pathological microenvironment, and highlights multi-field combination, microenvironment remodeling, and precise energy regulation as future directions for MPE therapy.
.