Stereotactic radiosurgery versus combined stereotactic radiosurgery and bevacizumab for recurrent glioblastoma; a systematic review and meta-analysis of survival.

Humans Radiosurgery / methods Bevacizumab / therapeutic use Glioblastoma / therapy Brain Neoplasms / therapy Neoplasm Recurrence, Local Antineoplastic Agents, Immunological / therapeutic use Combined Modality Therapy
Bevacizumab Meta-analysis Recurrent glioblastoma Stereotactic radiosurgery Survival outcomes

Journal

Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181

Informations de publication

Date de publication:
13 Jul 2024
Historique:
received: 28 12 2023
accepted: 08 07 2024
revised: 21 05 2024
medline: 14 7 2024
pubmed: 14 7 2024
entrez: 13 7 2024
Statut: epublish

Résumé

Recurrent glioblastoma (rGBM) is a brain tumor that is resistant to standard treatments. Although stereotactic radiosurgery (SRS) is a non-invasive radiation technique, it cannot fully prevent tumor recurrence and progression. Bevacizumab blocks tumor blood supply and has been approved for rGBM. However, the best way to combine SRS and bevacizumab is still unclear. We did a systematic review and meta-analysis of studies comparing SRS alone and SRS plus bevacizumab for rGBM. We searched three databases for articles published until June 2023. All statistical analysis was performed by STATA v.17. Our meta-analysis included 20 studies with 926 patients. We found that the combination therapy had a significantly lower rate of overall survival (OS) than SRS alone at 6-month 0.77[95%CI:0.74-0.85] for SRS alone and (100%) for SRS plus bevacizumab. At 1-year OS, 0.39 [95%CI: 0.32-0.47] for SRS alone and 0.61 [95%CI:0.44-0.77] for SRS plus bevacizumab (P-value:0.02). However, this advantage was not seen in the long term (18 months and two years). Additionally, the combination therapy had lower chances of progression-free survival (PFS) than SRS alone at the 6-month and 1-year time points, but the differences were insignificant. Our study indicates that incorporating bevacizumab with SRS may lead to a short-term increase in OS for rGBM patients but not long-term. Additionally, the PFS rate did not show significant improvement in the group receiving combination therapy. Further clinical trials are necessary to validate the enhanced overall survival with combination therapy for rGBM.

Identifiants

DOI: 10.1007/s10143-024-02585-9 PMID: 39002028
pubmed: 39002028
doi: 10.1007/s10143-024-02585-9
pii: 10.1007/s10143-024-02585-9
doi:

Substances chimiques

Bevacizumab 2S9ZZM9Q9V
Antineoplastic Agents, Immunological 0

Types de publication

Systematic Review Journal Article Meta-Analysis Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

323

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Mohammad Amin Habibi (MA)

Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. mohammad.habibi1392@yahoo.com.
ORCID: 0000-0001-7600-6925

Mohammad Ghorbani (M)

Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
ORCID: 0000-0002-1097-4509

Saeid Esmaeilian (S)

General Radiologist, Shiraz University of Medical Sciences, Shiraz, Iran.

Forouhar Tajvidi (F)

Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran.
ORCID: 0000-0003-4746-7620

Parham Nekutalaban (P)

Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran.

Amir Reza Boskabadi (AR)

Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Fakhroddin Alemi (F)

Faculty of Medicine, Mazandaran University of Medical Science, Mazandaran, Iran.

Rasa Zafari (R)

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Mohammad Sina Mirjani (MS)

Student Research Committee, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.

SeyedMohammad Eazi (S)

Student Research Committee, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.

Poriya Minaee (P)

Student Research Committee, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.

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questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Stereotactic radiosurgery versus combined...
questionsmedicales.fr › Techniques d'investigation › Techniques stéréotaxiques › Radiochirurgie › Stereotactic radiosurgery versus combined...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Anticorps monoclonaux › Anticorps monoclonaux humanisés › Bévacizumab › Stereotactic radiosurgery versus combined...
questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs du tissu nerveux › Tumeurs neuroectodermiques › Tumeurs neuroépitheliales › Gliome › Astrocytome › Glioblastome › Stereotactic radiosurgery versus combined...
questionsmedicales.fr › Maladies du système nerveux › Tumeurs du système nerveux › Tumeurs du système nerveux central › Tumeurs du cerveau › Stereotactic radiosurgery versus combined...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › Stereotactic radiosurgery versus combined...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Antinéoplasiques › Antinéoplasiques immunologiques › Stereotactic radiosurgery versus combined...
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