Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
J Cancer Res Clin Oncol. 2013 May;139(5):719-26. doi: 10.1007/s00432-013-1387-3. Epub 2013 Feb 10.
The aim of this study was to answer whether overall survival and progression-free survival are increased in patients with anaplastic glioma who are treated with radiotherapy plus chemotherapy as compared with those who treated with radiotherapy alone.
Searches of the MEDLINE (PubMed), Embase and Cochrane Library from January 2001 to May 2012 for relevant trials were undertaken. Selected studies based on the following criteria: First, only randomized clinical trial of adjuvant radiotherapy plus chemotherapy versus radiotherapy alone was permitted. Second, overall survival and/or progression-free survival was compared with patients in the studies. Third, cases were medically confirmed of anaplastic glioma.
4 randomized clinical trials were found eligible for this article (involving a total of 963 patients). The meta-analysis showed a significant increase in overall survival in patients treated with radiotherapy plus chemotherapy (HR = 0.84, 95 % CI 0.72-0.98, P = 0.031).
Results of our meta-analysis indicated that adjuvant chemotherapy played a beneficial role in the treatment for anaplastic gliomas. But the role of adjuvant chemotherapy in the treatment for anaplastic astrocytoma or anaplastic oligodendroglioma/anaplastic oligoastrocytoma still needs further large randomized trials to demonstrate.
本研究旨在回答与单独接受放疗相比，接受放化疗治疗的间变性神经胶质瘤患者的总生存期和无进展生存期是否提高。
从 2001 年 1 月至 2012 年 5 月，对 MEDLINE（PubMed）、Embase 和 Cochrane Library 进行了相关试验的检索。选择的研究基于以下标准：第一，仅允许辅助放疗加化疗与单独放疗的随机临床试验。第二，比较了研究中患者的总生存期和/或无进展生存期。第三，病例经医学确认为间变性神经胶质瘤。
发现 4 项随机临床试验符合本文要求（共涉及 963 例患者）。荟萃分析显示，接受放化疗治疗的患者总生存期显著提高（HR=0.84，95%CI 0.72-0.98，P=0.031）。
我们的荟萃分析结果表明，辅助化疗在治疗间变性神经胶质瘤方面发挥了有益作用。但是辅助化疗在治疗间变性星形细胞瘤或间变性少突胶质细胞瘤/间变性少突星形细胞瘤中的作用仍需要进一步的大型随机试验来证明。
