Luiz Victor Maia Loureiro1, Elivane da Silva Victor2, Donato Callegaro-Filho2, Ludmila de Oliveira Koch2, Lucíola de Barros Pontes3, Eduardo Weltman4, Edna Terezinha Rother2, Suzana Maria Fleury Malheiros5. 1. Hospital Israelita Albert Einstein, São Paulo, Brazil; Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina - Pós-graduação de Neurologia e Neurociências, São Paulo, Brazil. Electronic address: lvmaia@gmail.com. 2. Hospital Israelita Albert Einstein, São Paulo, Brazil. 3. Hcor Hospital do Coração Oncologia, São Paulo, Brazil. 4. Hospital Israelita Albert Einstein, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo, Brazil. 5. Hospital Israelita Albert Einstein, São Paulo, Brazil; Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina - Pós-graduação de Neurologia e Neurociências, São Paulo, Brazil.
Abstract
BACKGROUND AND PURPOSE: Previous studies have provided no clear conclusions regarding the effects of delaying radiotherapy (RT) in GBM patients. We present a systematic review and meta-analysis to address the effect of delayed RT on the overall survival (OS) of GBM patients. METHODS: A systematic search retrieved 19 retrospective studies published between 1975 and 2014 reporting on the waiting time (WT) to RT for GBM patients. The meta-analysis was performed by converting WT to RT studies intervals into a regression coefficient (β) and standard error expressing the effect size on OS per week of delay. RESULTS: Data required to calculate the effect size on OS per week of delay were available for 12 studies (5212 patients). A non-adjusted model and a meta-regression model based on well-recognized prognostic factors were performed. No association between WT to RT, per week of delay, and OS was found (HR=0.98; 95% CI 0.90-1.08; p=0.70). The meta-regression adjusted for prognostic factors weighted by the inverse-variance (1/SE(2)) showed no clear evidence of the effect of WT to RT, per week of delay, on OS. CONCLUSIONS: This meta-analysis, despite limitations, provided no evidence of a true effect on OS by delaying RT in GBM patients.
BACKGROUND AND PURPOSE: Previous studies have provided no clear conclusions regarding the effects of delaying radiotherapy (RT) in GBMpatients. We present a systematic review and meta-analysis to address the effect of delayed RT on the overall survival (OS) of GBMpatients. METHODS: A systematic search retrieved 19 retrospective studies published between 1975 and 2014 reporting on the waiting time (WT) to RT for GBMpatients. The meta-analysis was performed by converting WT to RT studies intervals into a regression coefficient (β) and standard error expressing the effect size on OS per week of delay. RESULTS: Data required to calculate the effect size on OS per week of delay were available for 12 studies (5212 patients). A non-adjusted model and a meta-regression model based on well-recognized prognostic factors were performed. No association between WT to RT, per week of delay, and OS was found (HR=0.98; 95% CI 0.90-1.08; p=0.70). The meta-regression adjusted for prognostic factors weighted by the inverse-variance (1/SE(2)) showed no clear evidence of the effect of WT to RT, per week of delay, on OS. CONCLUSIONS: This meta-analysis, despite limitations, provided no evidence of a true effect on OS by delaying RT in GBMpatients.
Authors: C Balaña; A Estival; I Teruel; M Hardy-Werbin; J Sepulveda; E Pineda; M Martinez-García; O Gallego; R Luque; M Gil-Gil; C Mesia; S Del Barco; A Herrero; A Berrocal; P Perez-Segura; R De Las Penas; J Marruecos; R Fuentes; G Reynes; J M Velarde; A Cardona; E Verger; C Panciroli; S Villà Journal: Clin Transl Oncol Date: 2018-05-08 Impact factor: 3.405
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