Evans Mia, Gill Ria, Bull Kim S
Faculty of medicine, University of Southampton, Southampton, UK.
Clinical and Experimental Sciences, University of Southampton, Southampton, UK.
Neurooncol Adv. 2022 Jun 24;4(1):vdac100. doi: 10.1093/noajnl/vdac100. eCollection 2022 Jan-Dec.
There are no effective treatments for diffuse intrinsic pontine glioma (DIPG); median survival is 11.2 months. Bevacizumab has the potential to improve quality of life (QOL) and survival in DIPG but has never been evaluated systematically. The aim of this review was to assess Bevacizumab's role in the treatment of DIPG.
MEDLINE, EMBASE, Scopus, and Web of Science were searched for relevant studies using terms developed from alternatives for Bevacizumab and DIPG. One reviewer screened titles and abstracts, then two reviewers screened full texts. Data were extracted into tables and quality assessed using methodological index for non-randomized studies and JBI tools.
Searching revealed 1001 papers; after deduplication 851 remained. After screening of titles and abstracts, then 28 full texts, 11 studies were included. Four studies reported a median overall survival longer than historical data, however, two found no significant impact of Bevacizumab. Five studies reported a radiological response in a proportion of participants and two reported no response. Three studies, evaluating clinical response, reported improvement in a proportion of patients. Three studies, evaluating QOL, reported stability or improvement. Four studies, evaluating steroid use, reported reductions in the proportion of patients receiving steroids. In radiation necrosis treatment, Bevacizumab led to clinical improvement in 6/12 patients in 2 studies and permitted a reduction in steroid use in most patients.
Insufficient evidence means the role of Bevacizumab in the treatment of DIPG is unclear. However, Bevacizumab may be beneficial to some patients. The review highlights the need for further research in this area.
弥漫性脑桥内胶质瘤（DIPG）尚无有效治疗方法；中位生存期为11.2个月。贝伐单抗有可能改善DIPG患者的生活质量（QOL）并延长生存期，但从未进行过系统评估。本综述的目的是评估贝伐单抗在DIPG治疗中的作用。
使用从贝伐单抗和DIPG的替代词衍生而来的术语，在MEDLINE、EMBASE、Scopus和科学网中检索相关研究。一名评审员筛选标题和摘要，然后两名评审员筛选全文。数据被提取到表格中，并使用非随机研究的方法学指数和JBI工具进行质量评估。
检索到1001篇论文；去重后剩下851篇。在筛选标题和摘要后，接着筛选28篇全文，纳入了11项研究。四项研究报告的中位总生存期长于历史数据，然而，两项研究发现贝伐单抗没有显著影响。五项研究报告了一部分参与者有放射学反应，两项研究报告无反应。三项评估临床反应的研究报告了一部分患者有改善。三项评估生活质量的研究报告生活质量稳定或改善。四项评估类固醇使用情况的研究报告接受类固醇治疗的患者比例有所降低。在放射性坏死治疗中，两项研究中的6/12例患者使用贝伐单抗后临床症状改善，且大多数患者类固醇使用量减少。
证据不足意味着贝伐单抗在DIPG治疗中的作用尚不清楚。然而，贝伐单抗可能对某些患者有益。本综述强调了该领域进一步研究的必要性。
