Radiotherapy with temozolomide provides better survival in the newly diagnosed glioblastoma multiforme: A meta-analysis.

Background: The optimal treatment for patients with newly diagnosed glioblastoma multiforme (GBM) remains controversial. The purpose of this meta-analysis was to systematically evaluate radiotherapy/temozolomide (TMZ) versus radiotherapy for treating newly diagnosed GBM.

Methods: Six electronic databases (PubMed, EMBASE, MEDLINE, Web of Science, Cochrane Library, and CNKI) were searched for relevant publications up to November 05, 2014. RevMan version 5.2 software was used for statistical analysis.

Results: A total of 9 studies were identified in this analyses, which included 986 patients. The summary risk ratio (RR) for overall survival and the progression-free survival (PFS) was the measure of interest. Results revealed that the addition of TMZ to radiotherapy resulted in a statistically significant survival benefit in poor prognosis patients with newly diagnosed glioblastoma (RR = 2.93 [95% confidence interval (CI) 2.29, 3.75], P < 0.00001). Moreover, radiotherapy plus TMZ was more beneficial than radiotherapy alone in improving PFS (RR = 3.52, [95% CI 2.53, 4.89], P < 0.00001). However, certain grade 3-4 hematological toxicities were significantly more common with TMZ.

Conclusions: This meta-analysis suggests that radiotherapy/TMZ provides better survival than radiotherapy alone in treating GBM.