Bevacizumab Plus Radiotherapy -Temozolomide In The Treatment Of Newly Diagnosed Glioblastoma Efficacy And Safety:A Systematic Review

Objective:To assess the efficacy and safety of Bevacizumab Integrated with Radiotherapy-Temozolomide in the treatment of newly diagnosed glioblastoma.Methods:Computer retrieved was conducted to search forall relevant clinical research in the electronic databases:PubMed, The Cochrane Library, EMBASE, Wanfang Date.Two researchers assessed the quality of the trials and extracted data independently.The data was analyzed by RevMan 5.3 software,and The quality of included trials was critically evaluated by Manual evaluation of Cochrane system.Result:A total of 4 prospective clinical trials, of which two were RCTs,including 1773 patients,891 cases in test group,882 cases in the control group. The Systematic Review showed that:Bevacizumab combined with temozolomide to radiotherapy in treatment of newly diagnosed glioblastoma could increase 6-month PFS (I2=14%, RR-0.44,95% CI:0.37-0.52, P< 0.00001).12-month PFS (I2=0%, RR=0.78,95% CI:0.73～0.84,P<0.00001) and 12-month OS (I2=6%, RR=0.86,95%CI:0.74～0.99, P=0.03).However, Bevacizumab could increase the incidence of hypertension、bleeding and other adverse events,but all adverse events after treatment to ease.Conclusions:Bevacizumab Integrated with Temozolomide in the treatment of newly diagnosed glioblastoma can prolong progression-free survival,the overall survival only extended trend, but based on less number of RCTs, so it is not enough to explain whether Bevacizumab can make the survival benefit in patients with newly diagnosed glioblastoma.And during the application will appear serious side reaction.Therefore, it is suggested that large-scale prospective phase Ⅲ clinical trials should be performed.