DataSheet2_The Prognostic Effect of Dexamethasone on Patients With Glioblastoma: A Systematic Review and Meta-Analysis.PDF
Background: Dexamethasone (DEX) is widely adopted to reduce tumor-associated edema in glioblastoma (GBM) patients despite its side effects. However, the benefits of using DEX in GBM patients remains elusive.
Methods: In this study, we performed a comprehensive meta-analysis to address this concern. We searched the relevant studies from PubMed, Web of Science, and EMBASE databases, and then applied random or fixed-effects models to generate estimated summary hazard radios (HRs) and the 95% confidence intervals (CIs). Moreover, subgroup and sensitivity analysis were conducted and publication bias were further evaluated.
Results: Ten articles with a total of 2,230 GBM patients were eligible according to the inclusion criteria. In the assessment of overall survival (OS), meta-analysis data revealed that DEX was significantly associated with the poor prognosis of GBM patients (HR=1.44, 95% CI=1.32−1.57). In the progression-free survival (PFS), the pooled results indicated that the use of DEX can increase 48% death risk for GBM patients (HR=1.48, 95% CI=1.11−1.98). Subgroup analyses revealed that DEX was associated with poorer outcome of GBM in subgroup of newly diagnosed patients and GBM patients treated with ≥ 2mg/day. Sensitivity analyses showed that no study changed the pooled results materially for both OS and PFS analyses. The funnel plot had no obvious asymmetry.
Conclusion: Our findings partly confirmed that use of DEX was associated with poor treatment outcome in GBM patients. To reach a definitive conclusion, large samples from multi-centers are urgent to address this concern.
History
References
- https://doi.org//10.1007/BF01405532
- https://doi.org//10.1093/neuonc/noy056
- https://doi.org//10.1016/j.jocn.2016.03.010
- https://doi.org//10.3389/fnmol.2019.00065
- https://doi.org//10.1200/JCO.2008.19.1098
- https://doi.org//10.1177/0271678X19859847
- https://doi.org//10.1007/s11060-018-2761-4
- https://doi.org//10.1016/j.brainres.2008.12.080
- https://doi.org//10.1016/j.brainres.2007.05.053
- https://doi.org//10.1002/ana.410190411
- https://doi.org//10.1056/NEJMoa043331
- https://doi.org//10.1007/BF00172664
- https://doi.org//10.1007/s00520-001-0333-0
- https://doi.org//10.1007/s11060-019-03146-7
- https://doi.org//10.1158/1078-0432.CCR-20-2291
- https://doi.org//10.1016/j.bbrc.2008.05.025
- https://doi.org//10.14791/btrt.2020.8.e12
- https://doi.org//10.1186/s13014-019-1427-5
- https://doi.org//10.1158/1078-0432.CCR-20-2500
- https://doi.org//10.1186/s13014-015-0527-0
- https://doi.org//10.1007/s10654-010-9491-z
- https://doi.org//10.1007/s00415-008-0695-z
- https://doi.org//10.1212/wnl.44.4.675
- https://doi.org//10.1056/NEJMra0708126
- https://doi.org//10.1038/bjc.2015.238