Survival outcomes in pediatric recurrent high-grade glioma: results of a 20-year systematic review and meta-analysis

被引:53
作者
Kline, Cassie [1 ,2 ]
Felton, Erin [2 ]
Allen, I. Elaine [3 ]
Tahir, Peggy [4 ]
Mueller, Sabine [1 ,2 ,5 ]
机构
[1] Univ Calif San Francisco, Div Hematol Oncol, Dept Pediat, 550 16th St,4th Floor, San Francisco, CA 94158 USA
[2] Univ Calif San Francisco, Dept Neurol, Sandler Neurosci 550, 625 Nelson Rising Lane,402B,Box 0434, San Francisco, CA 94158 USA
[3] Univ Calif San Francisco, Dept Epidemiol & Biostat, 550 16th St,2nd Floor, San Francisco, CA 94158 USA
[4] Univ Calif San Francisco, UCSF Lib, 530 Parnassus Ave, San Francisco, CA 94143 USA
[5] Univ Calif San Francisco, Dept Neurol Surg, 505 Parnassus Ave,M779, San Francisco, CA 94143 USA
基金
美国国家卫生研究院;
关键词
Pediatric high-grade glioma; Recurrence; Survival; Outcomes; MALIGNANT BRAIN-TUMORS; HIGH-DOSE CARMUSTINE; BONE-MARROW RESCUE; STEM-CELL RESCUE; CHILDREN; TEMOZOLOMIDE; CHEMOTHERAPY; CYCLOPHOSPHAMIDE; REIRRADIATION; VACCINATION;
D O I
10.1007/s11060-017-2701-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Recurrent pediatric high-grade glioma is a leading cause of cancer-related death in children. We report results of a systematic review and meta-analysis investigating survival outcome in pediatric patients with recurrent high-grade glioma over the last 20 years. MEDLINE/PubMed, EMBASE, Web of Science and Cochrane Review databases were searched for relevant studies reporting on survival outcomes for pediatric patients with recurrent high-grade glioma treated between 1996 and 2016. Progression-free survival (PFS) and overall survival (OS) were calculated cumulatively over all studies, by therapy subgroup, and by decade of treatment. Random effects models were used to control for heterogeneity as measured by the I-2 statistic. A total of 17 studies across 4 treatment strategies were included. Eleven investigated traditional chemotherapy, 1 investigated targeted therapy, 3 investigated immunotherapy, and 2 investigated radiotherapy. A total of 129 patients were included with a median age of 10.0 years. Cumulative PFS was 3.5 months (95% CI 2.1-5.0). Cumulative OS was 5.6 months (95% CI 3.9-7.3). OS was 4.0 months (95% CI 1.9-6.1) using traditional chemotherapy, 9.3 months using targeted therapies (95% CI 5.4-13), 6.9 months using immunotherapy (95% CI 2.1-12), and 14 months using reirradiation (95% CI 2.8-25). OS between 1996 and 2006 was 4.2 months (95% CI 2.1-6.2) compared to 8.5 months (95% CI 5.6-11) after 2006. Pediatric patients with recurrent high-grade glioma suffer from poor PFS and OS, regardless of therapy. There may be a trend towards improved OS in the last decade.
引用
收藏
页码:103 / 110
页数:8
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