A Systematic Review and Meta-Analysis on the Number of Adjuvant Temozolomide Cycles in Newly Diagnosed Glioblastoma.
The Stupp protocol
adjuvant
extended chemotherapy
glioblastoma
high-grade gliomas
temozolomide
treatment duration
Journal
Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867
Informations de publication
Date de publication:
2021
2021
Historique:
received:
18
09
2021
accepted:
29
10
2021
entrez:
13
12
2021
pubmed:
14
12
2021
medline:
14
12
2021
Statut:
epublish
Résumé
In newly diagnosed glioblastoma, radiation with concurrent and adjuvant (six cycles) temozolomide (TMZ) is the established standard of postsurgical care. However, the benefit of extending adjuvant TMZ therapy beyond six cycles has remained unknown. We searched PubMed, Web of Science, Scopus, and Embase up to October 1, 2021. The search keywords were "glioblastoma," "adjuvant chemotherapy," and their synonyms. The data of randomized clinical trials were extracted and included in this meta-analysis if they had reported patients' median overall survival (OS) or median progression-free survival (PFS). The standard and extended chemotherapy regimens were considered as adjuvant TMZ up to six cycles and beyond six cycles (up to a total of 12 cycles), respectively. The median OS and median PFS were pooled and compared. Four studies consisting of 882 patients (461 patients for the standard chemotherapy group and 421 patients for the extended chemotherapy group) were included in this meta-analysis. The extended TMZ regimen was associated with a nonsignificant improvement in PFS [12.0 months (95% CI 9.0 to 15.0) In newly diagnosed glioblastoma, continuing adjuvant TMZ beyond six cycles did not shown an increase neither in PFS nor OS.
Sections du résumé
BACKGROUND
BACKGROUND
In newly diagnosed glioblastoma, radiation with concurrent and adjuvant (six cycles) temozolomide (TMZ) is the established standard of postsurgical care. However, the benefit of extending adjuvant TMZ therapy beyond six cycles has remained unknown.
METHODS
METHODS
We searched PubMed, Web of Science, Scopus, and Embase up to October 1, 2021. The search keywords were "glioblastoma," "adjuvant chemotherapy," and their synonyms. The data of randomized clinical trials were extracted and included in this meta-analysis if they had reported patients' median overall survival (OS) or median progression-free survival (PFS). The standard and extended chemotherapy regimens were considered as adjuvant TMZ up to six cycles and beyond six cycles (up to a total of 12 cycles), respectively. The median OS and median PFS were pooled and compared.
RESULTS
RESULTS
Four studies consisting of 882 patients (461 patients for the standard chemotherapy group and 421 patients for the extended chemotherapy group) were included in this meta-analysis. The extended TMZ regimen was associated with a nonsignificant improvement in PFS [12.0 months (95% CI 9.0 to 15.0)
CONCLUSIONS
CONCLUSIONS
In newly diagnosed glioblastoma, continuing adjuvant TMZ beyond six cycles did not shown an increase neither in PFS nor OS.
Identifiants
pubmed: 34900732
doi: 10.3389/fonc.2021.779491
pmc: PMC8651479
doi:
Types de publication
Systematic Review
Langues
eng
Pagination
779491Informations de copyright
Copyright © 2021 Attarian, Taghizadeh-Hesary, Fanipakdel, Javadinia, Porouhan, PeyroShabany and Fazilat-Panah.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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