Adegboyega Gideon, Kanmounye Ulrick Sidney, Petrinic Tatjana, Ozair Ahmad, Bandyopadhyay Soham, Kuri Ashvin, Zolo Yvan, Marks Katya, Ramjee Serena, Baticulon Ronnie E, Vaqas Babar
Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, United Kingdom.
Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.
Int J Surg Protoc. 2021 Jun 25;25(1):108-113. doi: 10.29337/ijsp.148.
Glioblastoma multiforme is the most common and aggressive primary adult brain neoplasm. The current standard of care is maximal safe surgical resection, radiotherapy with concomitant temozolomide, followed by adjuvant temozolomide according to the Stupp protocol. Although the protocol is well adopted in high-income countries (HICs), little is known about its adoption in low- and middle-income countries (LMICs). The aim of this study is to describe a protocol design for a systematic review of published studies outlining the differences in GBM management between HICs and LMICs.
A systematic review will be conducted. MedLine via Ovid, Embase and Global Index Medicus will be searched from inception to date in order to identify the relevant studies. Adult patients (>18 years) with histologically confirmed primary unifocal GBM will be included. Surgical and chemoradiation management of GBM tumours will be considered. Commentaries, original research, non-peer reviewed pieces, opinion pieces, editorials and case reports will be included.
Primary outcomes will include rates of complications, disability-adjusted life years (DALYs), prognosis, progression-free survival (PFS), overall survival (OS) as well as rate of care abandonment and delay. Secondary outcomes will include the presence of neuro-oncology subspecialty training programs.
This systematic review will be the first to compare the current landscape of GBM management in HICs and LMICs, highlighting pertinent themes that may be used to optimise treatment in both financial brackets.
The protocol has been registered on the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020215843).
Glioblastoma multiforme (GBM) remains the most common primary adult cerebral neoplasm, with an age-adjusted incidence rate of 3.22 per 100,000 population and a 5-year survival rate of 6.8%Despite the well-evidenced efficacy of Stupp protocol, the implementation of this approach bears an institutional and individual financial burden that is particularly notable in low- and middle-income countries (LMICs)This systematic review will be the first to compare the current landscape of GBM management in HICs and LMICs, highlighting pertinent themes that may be used to optimise treatment in both financial brackets.
多形性胶质母细胞瘤是最常见且侵袭性最强的原发性成人大脑肿瘤。当前的治疗标准是进行最大安全限度的手术切除，同步放化疗联合替莫唑胺，随后根据Stupp方案进行辅助性替莫唑胺治疗。尽管该方案在高收入国家（HICs）得到了广泛应用，但对于其在低收入和中等收入国家（LMICs）的应用情况却知之甚少。本研究的目的是描述一个方案设计，用于对已发表研究进行系统综述，概述高收入国家和低收入及中等收入国家在胶质母细胞瘤管理方面的差异。
将进行一项系统综述。将检索从创刊至今的Ovid平台上的MedLine、Embase和全球医学索引，以识别相关研究。纳入年龄大于18岁、经组织学确诊为原发性单灶性胶质母细胞瘤的成年患者。将考虑胶质母细胞瘤肿瘤的手术及放化疗管理。评论、原创研究、非同行评审文章、观点文章、社论和病例报告均将纳入。
主要结局将包括并发症发生率、伤残调整生命年（DALYs）、预后、无进展生存期（PFS）、总生存期（OS）以及治疗放弃和延误率。次要结局将包括神经肿瘤亚专业培训项目的存在情况。
本系统综述将首次比较高收入国家和低收入及中等收入国家目前胶质母细胞瘤管理的情况，突出可能用于在这两类经济水平国家优化治疗的相关主题。
该方案已在国际前瞻性系统综述注册库（PROSPERO；注册号：CRD42020215843）注册。
多形性胶质母细胞瘤（GBM）仍然是最常见的原发性成人大脑肿瘤，年龄调整发病率为每10万人3.22例，5年生存率为6.8%。尽管Stupp方案的疗效有充分证据，但该方法的实施带来了机构和个人的经济负担，在低收入和中等收入国家（LMICs）尤为显著。本系统综述将首次比较高收入国家和低收入及中等收入国家目前胶质母细胞瘤管理的情况，突出可能用于在这两类经济水平国家优化治疗的相关主题。
