Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis

Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis

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<h4>Objective</h4> To evaluate different hypofractionated radiotherapy (HRT) regimens for newly diagnosed elderly glioblastoma (GBM) patients. <h4>Methods</h4> We performed a systematic review with network meta-analysis (NMA), including searches on CENTRAL, Medline, EMBASE, C...

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Autores principales: Suely Maymone de Melo, Gustavo Nader Marta, Carolina de Oliveira Cruz Latorraca, Camila Bertini Martins, Orestis Efthimiou, Rachel Riera
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Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2021
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Acceso en línea:https://doaj.org/article/84a5af65d0c64b21b63dc5e640ec16fa
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spelling oai:doaj.org-article:84a5af65d0c64b21b63dc5e640ec16fa2021-11-11T07:14:43ZHypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis1932-6203https://doaj.org/article/84a5af65d0c64b21b63dc5e640ec16fa2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568110/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4> To evaluate different hypofractionated radiotherapy (HRT) regimens for newly diagnosed elderly glioblastoma (GBM) patients. <h4>Methods</h4> We performed a systematic review with network meta-analysis (NMA), including searches on CENTRAL, Medline, EMBASE, CINAHL, clinical trial databases and manual search. Only randomized clinical trials (RCTs) were included. Primary outcomes: overall survival (OS) and adverse events (AE). Secondary outcomes: progression-free-survival (PFS) and quality of life (QoL). We used the Cochrane Risk of Bias (RoB) table for assessing individual studies and CINeMA for evaluating the certainty of the final body of evidence. <h4>Results</h4> Four RCTs (499 patients) were included. For OS, the estimates from NMA did not provide strong evidence of a difference between the HRTs: 40 Gray (Gy) versus 45 Gy (HR: 0.89; CI 95%: 0.42, 1.91); 34 Gy versus 45 Gy (HR: 0.85; CI 95% 0.43, 1.70); 25 Gy versus 45 Gy (HR: 0.81; CI 95% 0.32, 2.02); 34 Gy versus 40 Gy (HR: 0.95; CI 95% 0.57, 1.61); and 25 Gy versus 34 Gy (HR: 0.95; CI 95% 0.46, 1.97). We performed qualitative synthesis for AE and QoL due to data scarcity and clinical heterogeneity among studies. The four studies reported a similar QoL (assessed by different methods) between arms. One RCT reported grade ≥ 3 AE, with no evidence of a difference between arms. PFS was reported in one study (25 Gy versus 40 Gy), with no evidence of a difference between arms. <h4>Conclusion</h4> This review found no evidence of a difference between the evaluated HRTs for efficacy and safety.Suely Maymone de MeloGustavo Nader MartaCarolina de Oliveira Cruz LatorracaCamila Bertini MartinsOrestis EfthimiouRachel RieraPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Suely Maymone de Melo
Gustavo Nader Marta
Carolina de Oliveira Cruz Latorraca
Camila Bertini Martins
Orestis Efthimiou
Rachel Riera
Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis
description <h4>Objective</h4> To evaluate different hypofractionated radiotherapy (HRT) regimens for newly diagnosed elderly glioblastoma (GBM) patients. <h4>Methods</h4> We performed a systematic review with network meta-analysis (NMA), including searches on CENTRAL, Medline, EMBASE, CINAHL, clinical trial databases and manual search. Only randomized clinical trials (RCTs) were included. Primary outcomes: overall survival (OS) and adverse events (AE). Secondary outcomes: progression-free-survival (PFS) and quality of life (QoL). We used the Cochrane Risk of Bias (RoB) table for assessing individual studies and CINeMA for evaluating the certainty of the final body of evidence. <h4>Results</h4> Four RCTs (499 patients) were included. For OS, the estimates from NMA did not provide strong evidence of a difference between the HRTs: 40 Gray (Gy) versus 45 Gy (HR: 0.89; CI 95%: 0.42, 1.91); 34 Gy versus 45 Gy (HR: 0.85; CI 95% 0.43, 1.70); 25 Gy versus 45 Gy (HR: 0.81; CI 95% 0.32, 2.02); 34 Gy versus 40 Gy (HR: 0.95; CI 95% 0.57, 1.61); and 25 Gy versus 34 Gy (HR: 0.95; CI 95% 0.46, 1.97). We performed qualitative synthesis for AE and QoL due to data scarcity and clinical heterogeneity among studies. The four studies reported a similar QoL (assessed by different methods) between arms. One RCT reported grade ≥ 3 AE, with no evidence of a difference between arms. PFS was reported in one study (25 Gy versus 40 Gy), with no evidence of a difference between arms. <h4>Conclusion</h4> This review found no evidence of a difference between the evaluated HRTs for efficacy and safety.
format article
author Suely Maymone de Melo
Gustavo Nader Marta
Carolina de Oliveira Cruz Latorraca
Camila Bertini Martins
Orestis Efthimiou
Rachel Riera
author_facet Suely Maymone de Melo
Gustavo Nader Marta
Carolina de Oliveira Cruz Latorraca
Camila Bertini Martins
Orestis Efthimiou
Rachel Riera
author_sort Suely Maymone de Melo
title Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis
title_short Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis
title_full Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis
title_fullStr Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis
title_full_unstemmed Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis
title_sort hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: a systematic review and network meta-analysis
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/84a5af65d0c64b21b63dc5e640ec16fa
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AT rachelriera hypofractionatedradiotherapyfornewlydiagnosedelderlyglioblastomapatientsasystematicreviewandnetworkmetaanalysis
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