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Chemotherapy in adult high-grade glioma: a systematic review and
meta-analysis of individual patient data from 12 randomised trials
Glioma
Meta-analysis Trialists (GMT) Group
Correspondence to: Dr L A Stewart,
Meta-analysis Group, MRC Clinical Trials Unit, 222 Euston Road, London NW1 2DA,
UK (e-mail:ls@ctu.mrc.ac.uk)
Background.
Trials on the effect of systemic chemotherapy on survival and recurrence
in adults with high-grade glioma have had inconclusive results.
We undertook a
systematic review and meta-analysis to assess the effects of such treatment on
survival and recurrence.
Methods.
We did a systematic review and
meta-analysis using updated data on individual patients from all available
randomised trials that compared radiotherapy alone with radiotherapy plus
chemotherapy. Data for 3004 patients from 12 randomised controlled trials were
included (11 published and one unpublished).
Findings. Overall, the results showed significant prolongation of survival
associated with chemotherapy, with a hazard ratio of 0·85 (95% CI 0·78-0·91,
p<0·0001) or a 15% relative decrease in the risk of death. This effect is
equivalent to an absolute increase in 1-year survival of 6% (95% CI 3-9) from
40% to 46% and a 2-month increase in median survival time (1-3). There was no
evidence that the effect of chemotherapy differed in any group of patients
defined by age, sex, histology, performance status, or extent of resection.
Interpretation.
This small but clear
improvement in survival from chemotherapy encourages further study of drug
treatment of these tumours.
Source: http://www.thelancet.com/search/search.isa
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