Authors: Wei Wei Xin Chen Ximeng Ma Dawei Wang Zongze Guo
Publish Date: 2015/09/03
Volume: 125, Issue: 2, Pages: 339-349
Abstract
The goal of this metaanalysis was to identify the temozolomide TMZ regimen with optimal efficacy and tolerance for treatment of recurrent highgrade glioma HGG The PubMed and EMBASE databases were searched from the earliest records to February 2015 which identified 33 studies with 1760 participants that met the inclusion criteria The standard schedule and three most common dosedense regimens of TMZ therapy for recurrent HGG were included in this metaanalysis The schedule of 7 days on/7 days off for the treatment of grade IV gliomas was significantly superior to the standard regimen with respect to progressionfree survival at 6 months 348 95 confidence interval CI 270–434 and 12 months 155 95 CI 107–218 For grade III gliomas this regimen conveyed a significantly greater overall survival OS rate at 12 months 790 95 CI 562–917 as compared to the standard schedule Also the 21 days on/7 days off regimen had significantly longer OS rates at 6 months 736 95 CI 634–818 and 12 months 406 95 CI 326–486 than the standard regimen for grade IV gliomas In addition the standard schedule showed a significantly higher clinical benefit rate than the 7 days on/7 days off and 21 days on/7 days off regimens However the grade 3–4 toxicity rate of lymphopenia of the standard schedule was 765 95 CI 455–927 which was the highest among the four regimens Recurrent HGG patients receiving personalized treatment should be closely followed up especially those with concurrent hematological diseases
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