Tumor-treating fields as a fourth treating modality for glioblastoma: a meta-analysis

PAPER manual 2018 Meta-analysis Effect: benefit Evidence: Moderate

Read original paper → DOI: 10.1007/s00701 Evidence Lab

Abstract

Tumor-treating fields as a fourth treating modality for glioblastoma: a meta-analysis Magouliotis DE, Asprodini EK, Svokos KA, Tasiopoulou VS, Svokos AA, Toms SA. Tumor-treating fields as a fourth treating modality for glioblastoma: a meta-analysis. Acta Neurochir (Wien). 2018 Apr 25. doi: 10.1007/s00701- 018-3536-6. Abstract BACKGROUND: We aim to review the available literature on patients suffering from glioblastoma treated with tumor-treating fields (TTFields) plus radio chemotherapy or conventional radio chemotherapy alone, to compare the efficacy and safety of the two methods. METHODS: A systematic literature search was performed in PubMed, Cochrane library, and Scopus databases, in accordance with the PRISMA guidelines. Six studies met the inclusion criteria incorporating 1806 patients for the qualitative analysis and 1769 for the quantitative analysis. RESULTS: This study reveals increased median overall survival (weighted mean difference (WMD) 3.29 [95% confidence interval (CI) 2.37, 4.21]; p < 0.00001), survival at 1 year (odds ratio (OR) 1.81 [95% CI 1.41, 2.32]; p < 0.00001) and 2 years (OR 2.33 [95% CI 1.73, 3.14]; p < 0.00001), and median progression-free survival (WMD 2.35 [95% CI 1.76, 2.93]; p < 0.00001) along with progression-free survival at 6 months (WMD 6.86 [95% CI 5.91, 7.81]; p < 0.00001) for the patients treated with TTFields. Survival at 3 years was comparable between the two groups. TTFields were associated with fewer adverse events compared to chemotherapy along with similar incidence of skin irritation. CONCLUSIONS: TTFields are a safe and efficient novel treatment modality. More randomized controlled studies, with longer follow-up, are necessary to further assess the clinical outcomes of TTFields. ncbi.nlm.nih.gov

AI evidence extraction

At a glance

Study type

Meta-analysis

Effect direction

benefit

Population

Patients suffering from glioblastoma

Sample size

1769

Exposure

tumor-treating fields (TTFields)

Evidence strength

Moderate

Confidence: 78% · Peer-reviewed: yes

Main findings

Across six included studies, TTFields plus radio-chemotherapy was associated with increased median overall survival, 1- and 2-year survival, and median progression-free survival (including PFS at 6 months) compared with conventional radio-chemotherapy alone; 3-year survival was comparable between groups. TTFields were associated with fewer adverse events than chemotherapy and a similar incidence of skin irritation.

Outcomes measured

overall survival
survival at 1 year
survival at 2 years
survival at 3 years
progression-free survival
progression-free survival at 6 months
adverse events
skin irritation

Limitations

Only six studies included
Authors note need for more randomized controlled studies
Authors note need for longer follow-up

View raw extracted JSON

{
    "study_type": "meta_analysis",
    "exposure": {
        "band": null,
        "source": "tumor-treating fields (TTFields)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Patients suffering from glioblastoma",
    "sample_size": 1769,
    "outcomes": [
        "overall survival",
        "survival at 1 year",
        "survival at 2 years",
        "survival at 3 years",
        "progression-free survival",
        "progression-free survival at 6 months",
        "adverse events",
        "skin irritation"
    ],
    "main_findings": "Across six included studies, TTFields plus radio-chemotherapy was associated with increased median overall survival, 1- and 2-year survival, and median progression-free survival (including PFS at 6 months) compared with conventional radio-chemotherapy alone; 3-year survival was comparable between groups. TTFields were associated with fewer adverse events than chemotherapy and a similar incidence of skin irritation.",
    "effect_direction": "benefit",
    "limitations": [
        "Only six studies included",
        "Authors note need for more randomized controlled studies",
        "Authors note need for longer follow-up"
    ],
    "evidence_strength": "moderate",
    "confidence": 0.7800000000000000266453525910037569701671600341796875,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "tumor-treating fields",
        "TTFields",
        "glioblastoma",
        "meta-analysis",
        "PRISMA",
        "overall survival",
        "progression-free survival",
        "adverse events",
        "skin irritation"
    ],
    "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract/metadata and may be incomplete or incorrect. This content is for informational purposes only and is not medical advice.

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