Comparison of Infection Incidence Between Recurrent Glioblastoma Treatment Strategies: A Systematic Review and Meta-Analysis
Ashkan Pouyan MD1, Daniel Kheradmand MD2, Shahab Mahmoudnejad Fenderi MD2, Ali Teimouri MD3, Navid Ebrahimipour MD4, Mehran Alirezaei* MD2 and Sajjad Saghebdoust MD, MBA5
1Assistant Professor of Neurosurgery, Department of Neurosurgery, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
2Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
3Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
4Department of Emergency Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
5Department of Neurosurgery, Razavi Hospital, Mashhad, Iran
*Corresponding Author: Dr. Mehran Alirezaei, MD, Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Received: February 16, 2022 Published: February 24, 2022
Abstract
Background: The purpose of this study was to evaluate different chemotherapy regimens in the treatment of recurrent glioblastoma.
Methods: In this review, databases including Scopus, Google Scholar, ISI, and PubMed were reviewed using keywords of recurrent glioblastoma, Bevacizumab, infection. In this meta-analysis study, of all articles evaluating recurrent glioblastoma treatments, 19 articles reporting infection were selected, based on inclusion criteria, 11 articles were used to compare the incidence of infection in Bevacizumab based chemotherapy strategies, and seven articles were included in the Bayesian network meta-analysis for comparison between more various chemotherapy regimens. Cochran test was used to determine the homogeneity of the samples. The prevalence was estimated based on Random Effect in Revman software (version 3.5). Bayesian network meta-analysis was performed by NetMetaXL 1.6.1 software and winBUGS 1.4.3.
Results: A total of 11 studies with 776 subjects were evaluated to compare the incidence of infection in bevacizumab based drug regimens. There was a significant difference between the chemotherapy regimens (P <0.0008) in the sub total pooled random effect size. The lowest odd ratio of infection incidence was seen in the Bevacizumab+ Irinotecan chemotherapy regimen. Also, in a network meta-analysis of 1,169 patients, Temozolomide plus radiation was ranked as the best treatment to prevent infection (Surface Under Cumulative Ranking Curve (SUCRA) = 73%).
Conclusions: Among the conventional treatment regimens containing Bevacizumab, Bevacizumab + Irinotecan had the lowest incidence of infection. Compared with these diets with those without Bevacizumab, Temozolomide plus radiation has the lowest incidence.
Keywords: Bevacizumab, Infection, Recurrent Glioblastoma, Treatment Strategies
Citation: Pouyan A, Kheradmand D, Fenderi SM, Teimouri A, Ebrahimipour N, Alirezaei M, Saghebdoust S. “Comparison of Infection Incidence Between Recurrent Glioblastoma Treatment Strategies: A Systematic Review and Meta-Analysis”. SVOA Neurology 3:2 (2022) Pages 43-50.
