Abstract

Introduction

Despite aggressive treatment with chemoradiotherapy and maximum surgical resection, survival in patients with glioblastoma (GBM) remains poor. Ongoing efforts are aiming to prolong the lifespan of these patients; however, disparities exist in reported survival values with lack of clear evidence that objectively examines GBM survival trends. We aim to describe the current status and advances in the survival of patients with GBM, by analyzing median overall survival through time and between treatment modalities.

Methods

A systematic review was conducted according to PRISMA guidelines to identify articles of newly diagnosed glioblastoma from 1978 to 2018. Full-text glioblastoma papers with human subjects, ≥ 18 years old, and n ≥ 25, were included for evaluation.

Results

The central tendency of median overall survival (MOS) was 13.5 months (2.3–29.6) and cumulative 5-year survival was 5.8% (0.01%–29.1%), with a significant difference in survival between studies that predate versus postdate the implementation of temozolomide and radiation, [12.5 (2.3–28) vs 15.6 (3.8–29.6) months, P < 0.001]. In clinical trials, bevacizumab [18.2 (10.6–23.0) months], tumor treating fields (TTF) [20.7 (20.5–20.9) months], and vaccines [19.2 (15.3–26.0) months] reported the highest central measure of median survival.

Conclusion

Coadministration with radiotherapy and temozolomide provided a statistically significant increase in survival for patients suffering from glioblastoma. However, the natural history for GBM remains poor. Therapies including TTF pooled values of MOS and provide means of prolonging the survival of GBM patients.

中文翻译：

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胶质母细胞瘤的趋势：随着时间的推移和干预类型的结果：基于系统证据的分析。

摘要

介绍

尽管采用放化疗和积极的手术切除进行了积极治疗，但胶质母细胞瘤（GBM）患者的存活率仍然很差。正在进行的努力旨在延长这些患者的寿命。但是，报告的生存值存在差异，缺乏明确的证据客观地检查GBM生存趋势。我们旨在通过分析时间和治疗方式之间的总体中位生存率来描述GBM患者的当前状况和生存进展。

方法

根据PRISMA指南进行了系统评价，以鉴定1978年至2018年新诊断的胶质母细胞瘤的文章。纳入了受试者为≥18岁且n≥25的全文胶质母细胞瘤论文以进行评估。

结果

中位总体生存期（MOS）的集中趋势是13.5个月（2.3–29.6），累计5年生存期是5.8％（0.01％–29.1％），在实施或实施之前和之后的研究之间，生存率存在显着差异。替莫唑胺和放射治疗，[12.5（2.3–28）个月对15.6（3.8–29.6）个月，P <0.001]。在临床试验中，贝伐单抗[18.2（10.6–23.0）个月]，肿瘤治疗领域（TTF）[20.7（20.5–20.9）个月]和疫苗[19.2（15.3–26.0）个月]报告了中位生存期的最高中央指标。

结论

与放射疗法和替莫唑胺联用可为胶质母细胞瘤患者的生存率提供统计学上显着的增加。但是，GBM的自然历史仍然很差。包括TTF的MOS合并值在内的治疗方法可延长GBM患者的生存期。