Efficacy and safety of long-term therapy for high-grade glioma with temozolomide: A meta-analysis

Weilin Xu, Tao Li, Liansheng Gao, Jingwei Zheng, Anwen Shao and Jianmin Zhang _

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Oncotarget. 2017; 8:51758-51765. https://doi.org/10.18632/oncotarget.17401

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Weilin Xu1,*, Tao Li1,*, Liansheng Gao1,*, Jingwei Zheng1, Anwen Shao1 and Jianmin Zhang1,2,3

1Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

2Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China

3Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, China

*These authors have contributed equally to this work as co-first authors

Correspondence to:

Jianmin Zhang, email: [email protected]

Anwen Shao, email: [email protected]

Keywords: long-term, glioma, temozolomide, meta-analysis

Received: March 07, 2017     Accepted: April 04, 2017     Published: April 24, 2017


Further treatments are warranted in preventing recurrence or progression for high-grade glioma (HGG) patients having achieved stable disease with tolerable toxicity after the Stupp regimen (6 cycles of temozolomide). This meta-analysis aims to extensively evaluate the safety, feasibility, and efficacy of long-term therapy with temozolomide (>6 cycles) for these patients. We systematically searched the pubmed, Embase and Chinese Biomedical (CBM) databases using the strategy of combination of free-text words and MeSH terms. The efficacy indicators are hazard ratio (HR) for the pooled analysis of overall survival (OS) and progression free survival (PFS). The safety indicator is risk ratio (RR) for the pooled analysis of adverse effects. Six studies comprising a total number of 396 patients met all inclusion and exclusion criteria were included. No heterogeneity and publication bias were observed across each study. It was found that patients could obtain benefits from long-term administration of temozolomide both in OS (HR 2.39, 95% CI 1.82–3.14) and PFS (HR 2.12, 95% CI 1.56–2.89). In addition, the results showed that the patients receiving long-term administration of temozolomide did not experience additional toxicity over that of the Stupp regimen (6 cycles of temozolomide). It could be concluded that it’s efficacious and safe for HGG patients to receive long-term therapy with temozolomide. Nevertheless, more randomized controlled trials (RCTs) should be carried out to verify this conclusion.

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