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

J Cancer Res Clin Oncol. 2013 May;139(5):719-26. doi: 10.1007/s00432-013-1387-3. Epub 2013 Feb 10.


Object: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / therapy*
  • Combined Modality Therapy
  • Glioma / drug therapy
  • Glioma / radiotherapy
  • Glioma / therapy*
  • Humans
  • Odds Ratio
  • Publication Bias
  • Radiotherapy / adverse effects
  • Survival Analysis