Management of low-grade glioma: a systematic review and meta-analysis

Neuro-oncology Practice
Timothy J BrownMichael Glantz

Abstract

Optimum management of low-grade gliomas remains controversial, and widespread practice variation exists. This evidence-based meta-analysis evaluates the association of extent of resection, radiation, and chemotherapy with mortality and progression-free survival at 2, 5, and 10 years in patients with low-grade glioma. A quantitative systematic review was performed. Inclusion criteria included controlled trials of newly diagnosed low-grade (World Health Organization Grades I and II) gliomas in adults. Eligible studies were identified, assigned a level of evidence for every endpoint considered, and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality and of progression at 2, 5, and 10 years was calculated for patients undergoing resection (gross total, subtotal, or biopsy), radiation, or chemotherapy. Gross total resection was significantly associated with decreased mortality and likelihood of progression at all time points compared to subtotal resection. Early radiation was not associated with decreased mortality; however, progression-free survival was better at 5 years compared to patients receiving delayed or no radiation. Chemotherapy was associated...Continue Reading

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Citations

Oct 24, 2019·Pediatric Hematology and Oncology·Marie-Sophie MerlinJean-Louis Merlin
Mar 18, 2020·Journal of Cellular and Molecular Medicine·Shiqi KongYan Meng
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Oct 17, 2020·CNS Neuroscience & Therapeutics·Guanzhang LiWei Zhang
Oct 30, 2020·Frontiers in Oncology·Karanbir BrarAlireza Mansouri

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