Abstract
Background: Dexamethasone (DEX) is widely adopted to reduce tumor-associated edema in glioblastoma (GBM) patients despite its side effects. However, the benefits of using DEX in GBM patients remains elusive.Methods: In this study, we performed a comprehensive meta-analysis to address this concern. We searched the relevant studies from PubMed, Web of Science, and EMBASE databases, and then applied random or fixed-effects models to generate estimated summary hazard radios (HRs) and the 95% confidence intervals (CIs). Moreover, subgroup and sensitivity analysis were conducted and publication bias were further evaluated.Results: Ten articles with a total of 2,230 GBM patients were eligible according to the inclusion criteria. In the assessment of overall survival (OS), meta-analysis data revealed that DEX was significantly associated with the poor prognosis of GBM patients (HR=1.44, 95% CI=1.32−1.57). In the progression-free survival (PFS), the pooled results indicated that the use of DEX can increase 48% death risk for GBM patients (HR=1.48, 95% CI=1.11−1.98). Subgroup analyses revealed that DEX was associated with poorer outcome of GBM in subgroup of newly diagnosed patients and GBM patients treated with ≥ 2mg/day. Sensitivity analyses showed that no study changed the pooled results materially for both OS and PFS analyses. The funnel plot had no obvious asymmetry.Conclusion: Our findings partly confirmed that use of DEX was associated with poor treatment outcome in GBM patients. To reach a definitive conclusion, large samples from multi-centers are urgent to address this concern.
Highlights
Glioblastoma (GBM) is the most common form of primary brain tumors among adults (Wen and Kesari, 2008), with an extremely poor median survival outcome of 15.3–21.7 months (Hegi et al, 2005)
In the assessment of overall survival (OS), meta-analysis data revealed that DEX was significantly associated with the poor prognosis of GBM patients (HR 1.44, 95% confidence intervals (CIs) 1.32−1.57)
In the progression-free survival (PFS), the pooled results indicated that the use of DEX can increase 48% death risk for GBM patients (HR 1.48, 95% CI 1.11−1.98)
Summary
Glioblastoma (GBM) is the most common form of primary brain tumors among adults (Wen and Kesari, 2008), with an extremely poor median survival outcome of 15.3–21.7 months (Hegi et al, 2005). Many studies have reported that the use of DEX effectively improves neurologic symptoms caused by GBM (Vecht et al, 1994; Dubinski et al, 2019). A few clinical studies have been conducted to investigate the use of DEX in the treatment of GBM (Galicich and French, 1961; Galicich et al, 1961; Iorgulescu et al, 2021; Nayak et al, 2021). Lee et al reported that the use of DEX did not influence the overall survival (OS) of newly diagnosed GBM patients (Lee et al, 2020). Dexamethasone (DEX) is widely adopted to reduce tumor-associated edema in glioblastoma (GBM) patients despite its side effects. The benefits of using DEX in GBM patients remains elusive
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