放疗联合替莫唑胺治疗弥漫性内生性桥脑胶质瘤的预后影响：系统评价和荟萃分析。
The Prognostic Impact of Radiotherapy in Conjunction with Temozolomide in Diffuse Intrinsic Pontine Glioma: A Systematic Review and Meta-Analysis.
机构信息
Department of Neurosurgery, Tianjin Medical University, Tianjin, PR China; Department of Neurology, Tianjin Huanhu Hospital, Tianjin, PR China.
Tianjin Neurosurgical Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, PR China.
出版信息
World Neurosurg. 2021 Apr;148:e565-e571. doi: 10.1016/j.wneu.2021.01.024. Epub 2021 Jan 19.
OBJECTIVE
Diffuse intrinsic pontine glioma (DIPG) is a rare and devastating brainstem glioma that occurs predominately in children. To date, the prognostic impact of radiotherapy (RT) in conjunction with temozolomide (TMZ) in DIPG has not been thoroughly analyzed. The aim of this meta-analysis was to analyze the effectiveness of RT quantitatively and precisely in conjunction with TMZ in improving the prognosis of DIPG.
METHODS
A systematic search of 8 electronic databases was conducted. Articles mainly discussing the prognostic impact of RT in conjunction with TMZ in DIPG were selected. The pooled 1- and 2-year overall survival (OS) and progression-free survival (PFS) were calculated.
RESULTS
A total of 14 studies fulfilled our inclusion criteria, involving 283 cases of patients with DIPG who were treated with RT in conjunction with TMZ. The pooled 1- and 2-year OS of this treatment was 43% and 11%, respectively. The pooled 1- and 2-year PFS was 20% and 2%, respectively. Subgroup analysis revealed that the heterogeneity remained almost the same in all stratum. Egger's test demonstrated that the possibility of publication bias was low.
CONCLUSIONS
Requirements of up-to-date evidence on evaluating the prognostic impact of this therapy are urgent.
目的
弥漫性内在脑桥神经胶质瘤（DIPG）是一种罕见且具有破坏性的脑干神经胶质瘤，主要发生在儿童中。迄今为止，尚未对放射治疗（RT）联合替莫唑胺（TMZ）治疗 DIPG 的预后影响进行彻底分析。本荟萃分析的目的是定量和精确地分析 RT 联合 TMZ 治疗 DIPG 对改善预后的效果。
方法
系统地检索了 8 个电子数据库。选择主要讨论 RT 联合 TMZ 治疗 DIPG 的预后影响的文章。计算了汇总的 1 年和 2 年总生存率（OS）和无进展生存率（PFS）。
结果
共有 14 项研究符合我们的纳入标准，涉及 283 例接受 RT 联合 TMZ 治疗的 DIPG 患者。该治疗的 1 年和 2 年总生存率分别为 43%和 11%。1 年和 2 年无进展生存率分别为 20%和 2%。亚组分析表明，所有分层的异质性几乎相同。Egger 检验表明发表偏倚的可能性较低。
结论
迫切需要评估这种治疗方法预后影响的最新证据。
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