Table 1.
Characteristics of Clinical Trials Relating to Treatments (Surgery, Radiotherapy, Chemotherapy and chemoradiotherapy) for Glioma.
| First author/published year | Patients’ characteristics (mean age, M/F) | Intervention (number) | Comparison (number) | Results | Follow-up | Study design |
|---|---|---|---|---|---|---|
| Surgery | ||||||
| Gupta et al/2018 [3] | 6.3 (3.3-17.5), 23/27 | biopsy | NA | In 50 patients with DIPG going biopsy, 46 successfully captured tissue samples | Followed until death | Single-arm clinical trial |
| Kellermann et al/2017 [4] | 74 (70-87), 129/101 | stereotactic biopsy | NA | Two hundred and thirty nine of 230 elderly glioma patients received stereotactic biopsy, 222 achieved histopathologic diagnosis, and 171 received further adjuvant therapy | 1 year | Retrospective study |
| Tanaka et al/ 2013 [5] |
74.1 (66-87), 61/44 | stereotactic biopsy (52) | surgery (53) | Complications of postoperative bleeding is higher in patients undergoing stereotactic biopsy than in lesion removal surgery | 5 year | Retrospective study |
| Ostrom et al/ 2018[18] |
NA (59-64), 56/44 | NA | NA | Incidence of glioma and 1-year and 5-year survival rates vary significantly by race and ethnicity with non-Hispanic whites having higher incidence and lower survival rate. | 14 year | Retrospective study |
| Radiotherapy | ||||||
| Keime et al/2007[40] | 73 (70-85), 51/30 | radiotherapy plus supportive care (39) | supportive care (42) | Radiotherapy brings better outcome than supportive care in geriatric GBM patients | 4 year | RCT |
| Douw et al/ 2009[41] |
44.2, 35/30 | NA | NA | Side effect of cognitive loss could only be found in low-grade young glioma patients with RT hindering our decision making | 12 year | Prospective clinical study |
| Malmstrom et al/2012[42] | no less than 60, 118/80 | hypofractionated RT (98) | standard RT (100) | OS in geriatric GBM patients receiving hypofractionated RT is comparable in those with standard radiotherapy | 9 year | RCT |
| Roa et al/2004 [43] | elder than 60, 55/40 | standard RT (48) | short-course RT (47) | OS in geriatric GBM patients receiving hypofractionated RT is comparable in those with common radiotherapy | 5 year | RCT |
| Roa et al/2015 [44] | no less than 50, 46/52 | short-course RT (50) | standard RT (48) | Hypofractionated radiotherapy regimens did not reveal different OS | 3 year | RCT |
| Bent et al/2005[45] | 38.8, 191/115 | early RT (after surgery) (154) | deferred RT (152) | Early radiotherapy after surgery lengthened PFS but not progression-free survival (PFS) | 7.8 year | RCT |
| Chemotherapy and chemoradiotherapy | ||||||
| Malmstrom et al/2012 [42] | no less than 60, 173/118 | TMZ and hypofractionated RT (191) | standard RT (100) | Two weeks of massive fractionation RT or single TMZ could benefit geriatric GBM patients compared to six-week RT regimen | 9 year | RCT |
| Stupp et al/2009[56] | 360/213 | RT with concomitant adjuvant TMZ (287) | RT (286) | Six cycles of TMZ adjuvant chemoradiotherapy prolongs the survival of elderly patients with GBM | 2 year | RCT |
| Perry JR et al/2017[57] | 73 (65- 90), 43/219 | Short course RT (40Gy/15F) with concomitant adjuvant TMZ (281) | Short course RT (281) | The addition of temozolomide to short-course radiotherapy resulted in longer survival than short-course radiotherapy alone | Almost all followed until death | RCT |
Abbreviations: DIPG, diffuse intrinsic pontine glioma; OS, overall survival; PFS, progression-free survival; GBM, glioblastoma; RT, radiotherapy; TMZ, temozolomide; RCT, randomized controlled trial; NA, not available