Table 1.
Summary of Clinical and Socio-Demographic Characteristics of Studies
| Source | Study Design | Quality of Evidencea | Risk of Biasb | Intervention | Patients, No. | Age, y Median (Range) | KPS, Median (Range) | Male, n (%) | Recurrence Number | Daily Compliance, %(range) |
|---|---|---|---|---|---|---|---|---|---|---|
| Newly diagnosed GBM | ||||||||||
| Kirson et al. 2009 | P | 3 | 6 Stars | TTF + TMZ | 10 | 50 (32-70) | 90 (80-100) | 8 (80) | ||
| TMZ | 32c | |||||||||
| Stupp et al. 2017 (EF-14) | RCT | 2 | Some Concern | TTF + TMZ | 466 | 56 (19-83) | 90 (60-100) | 316 (68) | 75% of pt. ≥18 h/d | |
| TMZ | 229 | 57 (19-80) | 90 (70-100) | 157 (69) | ||||||
| Lu et al. 2019 | R | 3 | 7 Stars | TTF + TBI | 8 | |||||
| TTF + BBC | 12 | |||||||||
| Lazaridis et al. 2020 | R | 3 | TTF + CCNU + TMZ | 16 | 50 (27-70) | 90 (60-100) | 9 (66) | 83 (45-99) | ||
| Song et al. 2020 | P | 3 | TTF + TMZ + RT | 10 | 61 (49-73) | 90 (70-90) | 8 (80) | Concurrent phase 83.5 (49-93) Maintenance phase 77 (15-94) | ||
| Bokstein et al. 2020 | P | 3 | TTF + TMZ + RT | 10 | 60.2 (42-72) | 90 (80-100) | 8 (80) | RT: 79.3 (SD 8.36) First 3 months: 77.0 (SD 10.56) | ||
| Shi et al. 2020 | R | 3 | 6 Stars | TTFd | 5887 | <18: 0.3% 18-64: 69% ≥65: 30.7% | 3849 (65.4) | |||
| Recurrent GBM | ||||||||||
| Kirson et al. 2007 | P | 3 | 6 Stars | TTF | 10 | 53 (28-68) | 90 (70-100) | 7 (70) | Mean 18h/d | |
| Stupp et al. 2012 (EF-11) | RCT | 2 | Some Concern | TTF | 120 | 54 (24-80) | 80 (50-100) | 92 (77) | 1st: 9% 2nd: 48% ≥3rd: 43% | 86 (41-98) |
| BSC | 117 | 54 (29-74) | 80 (50-100) | 73 (62) | 1st: 15% 2nd: 46% ≥3rd: 39% | |||||
| Mrugala et al. 2014 (PRiDe) | R | 3 | 6 Stars | TTFd | 457 | 55 (18-86) | 80 (10-100) | 310 (67.6) | 1st: 33.3% 2nd: 26.9% ≥3rd: 27.4% Unknown: 12.5% | 70 (12-99) |
| BSC | 117 | 54 (29-74) | 80 (50-100) | 73 (62) | 1st: 15% 2nd: 46% ≥3rd: 39% | |||||
| Wong et al. 2015 | R | 3 | 6 Stars | TTF + BEV | 34 | 57 (30-77) | 70 (50-90) | 21 (62) | 1st: 17.6% 2nd: 26.5% ≥3rd: 55.9% | 83.5 |
| TTF + BEV + TCCC | 3 | 56 (51-56) | 70 (60-70) | 2 (66) | 1st: 0% 2nd: 66.6% ≥3rd: 33.3% | 66.7 | ||||
| Mahadevan et al. 2015 | R | 3 | 6 Stars | TTF ± SRS | 40 | 57 (47-79) | 24 (60) | |||
| Ansstas et al. 2016 | R | 4 | TTF | 8 | 51 (35-62) | 5 (62.5) | 3rd: 87.5% 4th: 12.5% | 74.2 (48.2-92.9) | ||
| Kesari et al. 2017 (EF-14) | RCT-PH | 2 | Some Concern | TTF + TMZ | 144 | 57 (29-83) | 90 (60-100) | 108 (75) | 1st: 100% | |
| TMZ | 60 | 58 (22-75) | 90 (70-100) | 45 (75) | 1st: 100% | |||||
| Lu et al. 2019 | R | 3 | 7 Stars | TTF + TBI | 18 | 57.8 (11.6)e | 12 (66.7) | |||
| TTF + BBC | 30 | 52.3 (9.9)e | 19 (63.3) | |||||||
| Korshoej et al. 2019 | P | 3 | TTF + SR Surgery | 15 | 57 (39-67) | ≥70 | 11 (73) | 1st: 100% | 90 (48-98) | |
| Onken et al. 2019 | O | 3 | 6 Stars | TTF + BSC | 30 | 52 (36-64) | 20 (67) | ndGBM:47% 1st: 53% | 1st month: 83 (40-97) 2nd month: 85 (56-97) | |
| BSC | 27 | 47e | 19 (70) | ndGBM: 100% | ||||||
| Zhu et al. 2020 (EF-19) | P | 3 | 6 Stars | TTF | 192 | 80 (9.83)e | 55.9 (12.2)e | 125 (65) | ||
| BSC | 117 | 80 (11.01)e | 53 (10.77)e | 73 (62) | 1st: 15% 2nd: 46% ≥3rd: 39% | |||||
| Fallah et al. 2020 | P | 3 | 7 Stars | TTF + BEV | 23 | 60 (17-78) | 18 (78) | |||
| Shi et al. 2020 | R | 3 | 6 Stars | TTFd | 4345 | <18: 0.5% 18-64: 76.8% ≥65: 22.7% | 2921 (67.2) |
Abbreviations: P, prospective; R, retrospective; RCT, randomized controlled trial; RCT-PH, post hoc analysis of RCT; O, observational study; TTF, Tumor-Treating Fields; TMZ, temozolomide; BSC, best standard of care; BEV, bevacizumab; TCCC, 6-thioguanine + lomustine + capecitabine + celecoxib; BBC, bevacizumab ± irinotecan or lomustine; TBI, temozolomide + bevacizumab + irinotecan; RT, radiotherapy; SR Surgery, skull-remodeling surgery; SRS, stereotactic radiosurgery.
aLevel of evidence according to Oxford Centre for Evidence-Based Medicine guidelines.
bRCTs: according to RoB 2 scale; non-RCTs: according to Newcastle-Ottawa Quality Assessment tool.
cHistorical control, matched on KPS and age.
dPatients may have received combination therapy in addition to TTFields.
eMean (SD).