Effectiveness and safety of postoperative radiotherapy plus temozolomide for treating brain malignant glioma ：a systematic review

Abstract:

Objective：To systematically review and analyze the effectiveness and safety of postoperative radiotherapy plus temozolo－mide for malignant glioma. Methods：A systematic literature retrieval was conducted in the Cochrane library，PubMed，Elsevier，EB－SCO，CBM，CNKI and Wanfangdata from 2011 to 2014 according to designed searching strategy and relevant words. Published ran－domized-controlled clinical trials（RCTs） concerning the postoperative radiotherapy plus temozolomide for malignant glioma were en－rolled. The quality of the included RCTs was analyzed using Cochrane systematic evaluation. Homogenous studies were analyzed using Cochrane Collaboration’s RevMan 5.0 software and the studies in which the data were unable to be merged were analyzed by de－scriptive qualitative analysis. Results：A total of 11 RCTs involving 590 patients（experimental group：298 patients；control group：292 patients） were included. Significant differences were found in the total effective rate（RR=1.77，95%CI=1.45 to 2.15，P=0.000），1-year survival rate（RR=1.38，95%CI=1.22 to 1.57，P=0.000），2-year survival rate（RR=1.91，95%CI=1.46 to 2.51，P=0.000），3-year survival rate（RR=2.51，95%CI=1.40 to 4.48，P=0.002） between postoperative radiotherapy plus temozolomide and postoperative ra－diotherapy alone. There was no statistical difference in adverse reaction between the two groups. Conclusion：Based on current clini－cal evidence，treatment of malignant glioma with postoperative radiotherapy plus temozolomide can improve effective rate and 1-，2-，3-year survival rates.