| Objective:The aim of this study was to answer whether overall survival and progression-free survival are increased in patients with anaplastic gliomas who are treated with radiotherapy plus chemotherapy as compared with those who treated with radiotherapy alone.Methods:Searche of the Medline (PubMed), Embase and Cochrane Library from January2001to May2013for relevant trials were undertaken. Selected studies based on the following criteria:First, only randomized clinical trial of adjuvant radiotherapy plus chemotherapy versus radiotherapy alone was permitted. Second, overall survival and/or progression-free survival was compared with patients in the studies. Third, cases were medically confirmed of anaplastic glioma.Results:4randomized clinical trials were found eligible for this article (involving a total of963patients). The meta analysis showed a significant increase in overall survival in patients treated with radiotherapy plus chemotherapy (HR=0.84,95%CI0.72-0.98, P=0.031).,and also in progression free survival (HR=0.68,95%CI (0.57,0.80), p=0.000). Subgroup analysis showed:AA group were compared with postoperative chemotherapy radiotherapy alone, there was no significant difference in overall survival time of combination therapy(HR=0.79,95%CI0.61-1.02, p=0.072), AO/AOA groups were similar results with AA(HR=0.87,95%CI0.71-1.07, p=0.183). With lp/19q chromosomal deletion heterozygous patients compared with patients not associated with lp/19q missing, overall survival was significantly improved(HR=0.299,95%CI0.207-0.433, P=0.000).Conclusions:Results of our meta-analysis indicated that adjuva nt chemotherapy played a beneficial role in the treatment for anapla stic gliomas.Chemoradiotherapy improves overall survival and progre ssion-free survival. patients associated with lp/19q missing overall survival time were significantly improved, Is a clinical predictor of better prognosis. |
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