Yang Yuan1, Wang Xiang2, Mao Qing3, Liu Yanhui4, Luo Jiewen5, Mao Yunhe6. 1. Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China. Electronic address: 76896489@qq.com. 2. Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China. Electronic address: 4589235@qq.com. 3. Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China. Electronic address: qingmao2000@163.com. 4. Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China. Electronic address: 827005432@qq.com. 5. Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China. Electronic address: 4155343@qq.com. 6. West China Medical School of Si Chuan University, Chengdu 610041, China. Electronic address: 297913442@qq.com.
Abstract
PURPOSE: Glioblastoma multiforme (GBM) is the most lethal type of primary brain tumor, and patients that undergo the maximum tumor resection that is safely possible and standard radiochemotherapy only achieve a median survival time of 14.6 months. Several clinical studies have reported that valproic acid could prolong survival of GBM patients. However, the results of these studies are inconsistent. We examined relevant studies and conducted a meta-analysis to assess the effects of VPA on survival times and recurrence. METHODS: A bibliographic search was performed in the EMBASE, MEDLINE, ClinicalTrials.gov and Cochrane Central Register of the Controlled Trials databases to identify potentially relevant articles or conference abstracts that investigated the effects of VPA on the outcome of glioma patients. Five observational studies were included. RESULTS: Pooled estimates of the hazard ratio (HR) and 95% confidence intervals (CI) were calculated. Our meta-analysis confirmed the benefit of using VPA (HR, 0.56; 95% CI, 0.44-0.71). Sub-group analysis shows that patients treated with VPA had a hazard ratio of 0.74 with a 95% confidence interval of 0.59-0.94 vs. patients treated by other-AEDs and a hazard ratio of 0.66 with a 95% confidence interval of 0.52-0.84 vs. patients treated by administration of non-AEDs. No heterogeneity was observed in the subset analysis. CONCLUSION: The results of our study suggest that glioblastoma patients may experience prolonged survival due to VPA administration. Sub-analysis confirmed the benefit of VPA use compared to a non-AEDs group and an other-AEDs group. Further RCTs of this subject should be performed.
PURPOSE:Glioblastoma multiforme (GBM) is the most lethal type of primary brain tumor, and patients that undergo the maximum tumor resection that is safely possible and standard radiochemotherapy only achieve a median survival time of 14.6 months. Several clinical studies have reported that valproic acid could prolong survival of GBM patients. However, the results of these studies are inconsistent. We examined relevant studies and conducted a meta-analysis to assess the effects of VPA on survival times and recurrence. METHODS: A bibliographic search was performed in the EMBASE, MEDLINE, ClinicalTrials.gov and Cochrane Central Register of the Controlled Trials databases to identify potentially relevant articles or conference abstracts that investigated the effects of VPA on the outcome of gliomapatients. Five observational studies were included. RESULTS: Pooled estimates of the hazard ratio (HR) and 95% confidence intervals (CI) were calculated. Our meta-analysis confirmed the benefit of using VPA (HR, 0.56; 95% CI, 0.44-0.71). Sub-group analysis shows that patients treated with VPA had a hazard ratio of 0.74 with a 95% confidence interval of 0.59-0.94 vs. patients treated by other-AEDs and a hazard ratio of 0.66 with a 95% confidence interval of 0.52-0.84 vs. patients treated by administration of non-AEDs. No heterogeneity was observed in the subset analysis. CONCLUSION: The results of our study suggest that glioblastomapatients may experience prolonged survival due to VPA administration. Sub-analysis confirmed the benefit of VPA use compared to a non-AEDs group and an other-AEDs group. Further RCTs of this subject should be performed.
Authors: A V Krauze; Mackey Megan; Cooley-Zgela Theresa; Mathen Peter; J H Shih; P J Tofilon; L Rowe; M Gilbert; K Camphausen Journal: Cancer Stud Ther Date: 2020-01-11
Authors: Kristin M Knudsen-Baas; Anders Engeland; Nils Erik Gilhus; Anette M Storstein; Jone F Owe Journal: J Neurooncol Date: 2016-07-04 Impact factor: 4.130
Authors: Dinesh Thotala; Rowan M Karvas; John A Engelbach; Joel R Garbow; Andrew N Hallahan; Todd A DeWees; Andrei Laszlo; Dennis E Hallahan Journal: Oncotarget Date: 2015-10-27