Intra-arterial chemotherapy is not superior to intravenous chemotherapy for malignant gliomas: a systematic review and meta-analysis.

The efficacy and safety of intra-arterial (IA) chemotherapy versus intravenous (IV) chemotherapy for malignant gliomas were studied. We searched eight electronic databases to identify relevant randomized controlled trials that compared IA chemotherapy with IV chemotherapy in patients with malignant gliomas. This study was conducted in compliance with the Quality of Reporting of Meta-analysis (QUORUM) guidelines. The quality of data was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Four eligible randomized controlled trials including 460 patients were retrieved. Comparing IA chemotherapy and IV chemotherapy for malignant gliomas, disease control rate, efficacy rate, 1-year, 2-year, and 3-year overall survival as well as grade 3/4 leukocytopenia, thrombocytopenia, and anemia were not statistically different. In conclusion, IA chemotherapy is not superior to IV chemotherapy in terms of efficacy and overall survival as a treatment for malignant gliomas.