Li Shupeng, Dong Jiawei, Wang Xinyu, Meng Xiangqi, Jiang Chuanlu, Cai Jinquan
Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
Chin Neurosurg J. 2022 Sep 3;8(1):24. doi: 10.1186/s41016-022-00294-0.
TTFields is a novel treating modality of glioblastoma (GBM) which can significantly prolong the overall survival (OS) of newly diagnosed or recurrent glioblastoma. Some researchers have revealed that a variety of factors can affect the efficacy of TTFields. So, we review the available literature about the influencing factors on efficacy of TTFields and then choose two experimentally supported factors: the dose of dexamethasone and compliance of TTFields to perform a meta-analysis. The PubMed, Embase, and the Cochrane Library are searched. Five articles are identified between 2014 and 2017. Three articles are about the compliance of TTFields. Two articles are about the dose of dexamethasone. The Newcastle-Ottawa Quality Assessment Scale (NOS) is used as an assessment tool to evaluate the methodological quality of all included trials. The scale's range varies from 0 to 9 stars. According to the Cochrane Handbook for Systematic Reviews of Interventions, articles are graded in six items to evaluate the risk of bias. Two reviewers rate the studies independently and the final decision is reached by consensus.Our data shows that the median OS is conspicuously longer in the TTFields group in which the dose of dexamethasone is ≤ 4.1 mg, WMD = 9.23 [95% CI 5.69-12.78]; P < 0.05). And the patients whose compliance of TTFields treatment ≥ 75% (≥ 18 h per day) have a significant lower overall survival risk than the patients whose compliance of TTFields treatment < 75% (HR = 0.57 [95% CI 0.46-0.70]; P < 0.00001).TTFields is a safe and efficient novel treatment modality. The dose of dexamethasone ≤ 4.1 mg of TTFields treatment and the compliance of TTFields treatment ≥ 75%, ≥ 18 h per day are beneficial to the prognosis of the glioblastoma patients.
肿瘤治疗电场（TTFields）是一种治疗胶质母细胞瘤（GBM）的新型疗法，可显著延长新诊断或复发性胶质母细胞瘤患者的总生存期（OS）。一些研究人员发现，多种因素会影响TTFields的疗效。因此，我们回顾了有关TTFields疗效影响因素的现有文献，然后选择两个有实验依据的因素：地塞米松剂量和TTFields治疗依从性进行荟萃分析。检索了PubMed、Embase和Cochrane图书馆。在2014年至2017年间共识别出5篇文章。其中3篇文章涉及TTFields治疗依从性，2篇文章涉及地塞米松剂量。采用纽卡斯尔-渥太华质量评估量表（NOS）作为评估工具，评价所有纳入试验的方法学质量。该量表的评分范围为0至9星。根据《Cochrane干预措施系统评价手册》，文章从六个方面进行评分，以评估偏倚风险。由两名评价员独立对研究进行评分，最终通过协商达成决定。我们的数据显示，地塞米松剂量≤4.1mg的TTFields治疗组的中位总生存期显著更长，加权均数差（WMD）=9.23[95%可信区间（CI）5.69 - 12.78]；P<0.05）。TTFields治疗依从性≥75%（每天≥18小时）的患者的总生存风险显著低于TTFields治疗依从性<75%的患者（风险比（HR）=0.57[95%CI 0.46 - 0.70]；P<0.00001）。肿瘤治疗电场是一种安全有效的新型治疗方式。TTFields治疗中地塞米松剂量≤4.1mg以及TTFields治疗依从性≥75%（每天≥18小时）有利于胶质母细胞瘤患者的预后。
