Chemotherapy plus radiotherapy versus radiotherapy alone in patients with anaplastic glioma: a systematic review and meta-analysis

The aim of this study was to answer whether overall survival and progression-free survival are increased in patients with anaplastic glioma who are treated with radiotherapy plus chemotherapy as compared with those who treated with radiotherapy alone. Searches of the MEDLINE (PubMed), Embase and Cochrane Library from January 2001 to May 2012 for relevant trials were undertaken. Selected studies based on the following criteria: First, only randomized clinical trial of adjuvant radiotherapy plus chemotherapy versus radiotherapy alone was permitted. Second, overall survival and/or progression-free survival was compared with patients in the studies. Third, cases were medically confirmed of anaplastic glioma. 4 randomized clinical trials were found eligible for this article (involving a total of 963 patients). The meta-analysis showed a significant increase in overall survival in patients treated with radiotherapy plus chemotherapy (HR = 0.84, 95 % CI 0.72-0.98, P = 0.031). Results of our meta-analysis indicated that adjuvant chemotherapy played a beneficial role in the treatment for anaplastic gliomas. But the role of adjuvant chemotherapy in the treatment for anaplastic astrocytoma or anaplastic oligodendroglioma/anaplastic oligoastrocytoma still needs further large randomized trials to demonstrate.