A network meta-analysis: the overall and progression-free survival of glioma patients treated by different chemotherapeutic interventions combined with radiation therapy (RT).

Ling Qi,Peng Lv,Shuran Wang,Yue Zhong,Weiyao Wang,Donghai Zhao,Lijuan Ding,Ling Gao,Shudong Wang,Ye Xu

doi:10.18632/oncotarget.10763

Ling Qi, Peng Lv + Show 8 more

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https://doi.org/10.18632/oncotarget.10763

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Abstract

Different chemotherapy drugs are generally introduced in clinical practices combining with therapy for glioma treatment. However, these chemotherapy drugs have rarely been compared with each other and the optimum drug still remains to be proved. In this research, medical databases were consulted, PubMed, Embase and Cochrane Library included. As primary outcomes, hazard ratio (HR) of overall survival (OS) and progression-free survival (PFS) with their corresponding 95% credential intervals (CrI) were reported. A network meta-analysis was conducted; the surface under the cumulative ranking curve (SUCRA) was utilized for treatment rank and a cluster analysis based on SUCRA values was performed. This research includes 14 trials with 3,681 subjects and eight interventions. In terms of network meta-analysis, placebo was proved to be inferior to the combination of temozolomide (TMZ), nimustine (ACNU) and cisplatin (CDDP). Also, bevacizumab (BEV) in conjunction with TMZ were significantly more effective than placebo with an HR of 0.40. The estimated probabilities from SUCRA verified the above outcomes, confirming that the combination of TMZ, ACNU and CDDP exhibited the highest ranking probability of 0.889 with respect to OS, while BEV in combination with TMZ - with a probability of 0.772 - ranked the first place with respect to PFS. According to the results of this network meta-analysis, the combination of (1) TMZ, ACNU and CDDP; (2) BEV in combination with TMZ and (3) cilengitide in combination with TMZ, are considered as the preferable choices of chemotherapy drugs for glioma treatment.

Highlights

Glioma tumours developed from neoplastic glial cells - which provide support and protection for the peripheral and central nerve system [1] are a common type of primary brain tumours
A total of 3,681 patients suffering from glioma were involved in this research and these patients were obtained from 14 randomized control trials or clinical trials
ACNU is considered as the second-line chemotherapeutic intervention for glioma patients since it has comparable permeability for overcoming the bloodbrain barriers

Summary

Introduction

Glioma tumours developed from neoplastic glial cells - which provide support and protection for the peripheral and central nerve system [1] are a common type of primary brain tumours This specific type of tumour accounts for approximately 30% of all brain and spine tumours and 80% of all malignant brain tumours [2]. Anaplastic astrocytomas (AA) and www.impactjournals.com/oncotarget glioblastomas (GB) are common types of stage III and IV glioma cases, and the five-year survival rate of GB patients is less than 3% [5] Another key factor for the prognosis of glioma patients is the onset age and a large number of studies have concluded that the average survival time of GB patients was negatively correlated to their ages at which GB was diagnosed [6]

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