Melo, Suely Maymone de; Marta, Gustavo Nader; Latorraca, Carolina de Oliveira Cruz; Martins, Camila Bertini; Efthimiou, Orestis; Riera, Rachel (2021). Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis. PLoS ONE, 16(11), e0257384. Public Library of Science 10.1371/journal.pone.0257384
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OBJECTIVE
To evaluate different hypofractionated radiotherapy (HRT) regimens for newly diagnosed elderly glioblastoma (GBM) patients.
METHODS
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.
RESULTS
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.
CONCLUSION
This review found no evidence of a difference between the evaluated HRTs for efficacy and safety.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) |
UniBE Contributor: |
Efthimiou, Orestis |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
1932-6203 |
Publisher: |
Public Library of Science |
Funders: |
[4] Swiss National Science Foundation |
Language: |
English |
Submitter: |
Andrea Flükiger-Flückiger |
Date Deposited: |
16 Nov 2021 20:05 |
Last Modified: |
04 Apr 2024 03:13 |
Publisher DOI: |
10.1371/journal.pone.0257384 |
PubMed ID: |
34735442 |
BORIS DOI: |
10.48350/160852 |
URI: |
https://boris.unibe.ch/id/eprint/160852 |
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