Objective: This study aims to assess the clinical efficacy and safety of bevacizumab combined with lobaplatin perfusion in treating malignant pleural[1]peritoneal effusions, particularly in athletic patients who may have specific physiological considerations due to their high physical activity levels. Methods: A total of 84 athletic patients with malignancies accompanied by malignant pleural-peritoneal effusions were selected at our hospital from May 2020 to May 2022. They were randomized into two groups: the combination group received bevacizumab with lobaplatin perfusion, while the single drug group received only lobaplatin perfusion. We compared clinical outcomes, levels of vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1α (HIF-1α), and carcinoembryonic antigen (CEA) in the effusions. Additionally, the self-rating depression scale (SDS), self-rating anxiety scale (SAS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were utilized to assess patients' psychological well-being and quality of life. Adverse effects were also recorded. Results: The combination group showed a higher total effective rate of treatment compared to the single drug group (P<0.05). Post-treatment, there was a significant reduction in the levels of VEGF, CEA, and HIF-1α in the> <0.05) Post-treatment, there was a significant reduction in the levels of VEGF, CEA, and HIF-1α in the combination group (P<0.05). Improvements in QLQ-C30 scores were observed in both groups, with higher scores in the combination group. Additionally, decreases in SAS and SDS scores were more pronounced in the combination group (P><0.05). The overall incidence of adverse reactions did not differ significantly between the groups (P>0.05). Conclusion: For athletic patients with malignant pleural-peritoneal effusions, the combination of bevacizumab and lobaplatin perfusion demonstrates greater efficacy and comparable safety to lobaplatin alone. This treatment approach offers potential advantages for athletic patients, considering their unique physiological and psychological needs