A network meta-analysis: the overall and progression-free survival of glioma patients treated by different chemotherapeutic interventions combined with radiation therapy (RT)

// Ling Qi 1,* , Lijuan Ding 2,* , Shuran Wang 3 , Yue Zhong 3 , Donghai Zhao 3 , Ling Gao 2 , Weiyao Wang 1 , Peng Lv 1 , Ye Xu 1 and Shudong Wang 4 1 Basic Medical College, Jilin Medical University, Jilin, China 2 Department of Radiation Oncology, First Hospital of Jilin University, Changchun, China 3 Department of Science and Technology, Jilin Medical University, Jilin, China 4 Center of Cardiovascular Diseases, First Hospital of Jilin University, Changchun, China * These authors have contributed equally to this work Correspondence to: Ye Xu, email: // Shudong Wang, email: // Keywords : chemotherapy, radiotherapy, glioma, network meta-analysis, temozolomide Received : April 05, 2016 Accepted : July 10, 2016 Published : July 21, 2016 Abstract Different chemotherapy drugs are generally introduced in clinical practices combining with therapy for glioma treatment. However, these chemotherapy drugs have rarely been compared with each other and the optimum drug still remains to be proved. In this research, medical databases were consulted, PubMed, Embase and Cochrane Library included. As primary outcomes, hazard ratio (HR) of overall survival (OS) and progression-free survival (PFS) with their corresponding 95% credential intervals ( CrI ) were reported. A network meta-analysis was conducted; the surface under the cumulative ranking curve (SUCRA) was utilized for treatment rank and a cluster analysis based on SUCRA values was performed. This research includes 14 trials with 3,681 subjects and eight interventions. In terms of network meta-analysis, placebo was proved to be inferior to the combination of temozolomide (TMZ), nimustine (ACNU) and cisplatin (CDDP). Also, bevacizumab (BEV) in conjunction with TMZ were significantly more effective than placebo with an HR of 0.40. The estimated probabilities from SUCRA verified the above outcomes, confirming that the combination of TMZ, ACNU and CDDP exhibited the highest ranking probability of 0.889 with respect to OS, while BEV in combination with TMZ - with a probability of 0.772 - ranked the first place with respect to PFS. According to the results of this network meta-analysis, the combination of (1) TMZ, ACNU and CDDP; (2) BEV in combination with TMZ and (3) cilengitide in combination with TMZ, are considered as the preferable choices of chemotherapy drugs for glioma treatment.