BACKGROUND Based on the effective radiological responses, bevacizumab (BEV) has been widely used in the treatment of recurrent high-grade glioma. Although the current standard dose is 5 mg/kg/week, the optimal dosage of BEV is controversial, as few dose-response studies have been performed in recent years. Therefore, we conducted a meta-analysis to explore the value of reduced-dose bevacizumab versus standard-dose bevacizumab in recurrent high-grade glioma treatment. METHODS Three major electronic databases (PubMed, EMBASE and the Cochrane Library) were searched for eligible documents published before February 2020. Literature on low-dose bevacizumab versus conventional dose in progressive high-grade glioma was included, and the endpoints of eligible researches should be progression-free survival (PFS) and overall survival (OS). All available data were collected and then analyzed with Stata software. RESULTS Four cohort studies were evaluated, including 552 patients (reduced-dose BEV group: 257, standard-dose BEV group: 295). Low dose BEV seems to slightly improve survival compared to conventional dose as HR < 1 indicates a protective effect, but no significant differences in OS (HR 0.77; 95 % CI 0.53-1.10; P = 0.151) and PFS (HR 0.66; 95 % CI 0.37-1.20; P = 0.175) were found between the two groups in this study. CONCLUSION Reduced-dose bevacizumab schedule resulted in similar OS and PFS to standard-dose bevacizumab in recurrent high-grade glioma, with less side effects and less cost of treatment. Therefore, low-dose bevacizumab represents a promising therapeutic option for recurrent high-grade glioma patients. Further prospective randomized trials are needed to confirm our results.

中文翻译：

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在复发性高级别胶质瘤中减少剂量的贝伐单抗与标准剂量的贝伐单抗：哪个更好？荟萃分析

背景基于有效的放射学反应，贝伐单抗（BEV）已广泛用于治疗复发性高级别胶质瘤。虽然目前的标准剂量是 5 mg/kg/周，但 BEV 的最佳剂量是有争议的，因为近年来很少进行剂量反应研究。因此，我们进行了一项荟萃分析，以探讨减少剂量贝伐单抗与标准剂量贝伐单抗在复发性高级别胶质瘤治疗中的价值。方法 检索 2020 年 2 月之前发表的三个主要电子数据库（PubMed、EMBASE 和 Cochrane Library）中符合条件的文献，纳入低剂量贝伐单抗与常规剂量治疗进展性高级别胶质瘤的文献，符合条件的研究终点应为无进展生存期（PFS）和总生存期（OS）。收集所有可用数据，然后使用 Stata 软件进行分析。结果 评估了四项队列研究，包括 552 名患者（减量 BEV 组：257，标准剂量 BEV 组：295）。与常规剂量相比，低剂量 BEV 似乎略微提高了生存率，因为 HR < 1 表明具有保护作用，但在 OS（HR 0.77；95 % CI 0.53-1.10；P = 0.151）和 PFS（HR 0.66；95 %）方面没有显着差异CI 0.37-1.20；P = 0.175) 在本研究中的两组之间发现。结论 在复发性高级别胶质瘤中，减少剂量的贝伐珠单抗方案与标准剂量的贝伐珠单抗产生相似的 OS 和 PFS，且副作用更少，治疗成本更低。因此，低剂量贝伐单抗代表了复发性高级别胶质瘤患者的一种有前景的治疗选择。