The Prognostic Impact of Radiotherapy in Conjunction with Temozolomide in Diffuse Intrinsic Pontine Glioma: A Systematic Review and Meta-Analysis.

Abstract Objective Diffuse intrinsic pontine glioma (DIPG) is a rare and devastating brainstem glioma that occurs predominately in children. To date, the prognostic impact of radiotherapy (RT) in conjunction with temozolomide (TMZ) in DIPG has not been thoroughly analyzed. The aim of this meta-analysis was to quantitatively and precisely analyze the effectiveness of RT in conjunction with TMZ in improving the prognosis of DIPG. Methods A systematic search of eight electronic databases was conducted. Articles mainly discussing the prognostic impact of RT in conjunction with TMZ in DIPG were selected. The pooled 1-year and 2-year overall survival (OS) and progression-free survival (PFS) were calculated. Results A total of 14 studies fulfilled our inclusion criteria, involving 283 cases of DIPG patients who were treated with RT in conjunction with TMZ. The pooled 1-year and 2-year OS of this treatment was 43% and 11%, respectively. The pooled 1-year and 2-year PFS of was 20% and 2%, respectively. Subgroup analysis revealed that the heterogeneity almost remained the same in all stratum. Egger’s test demonstrated the possibility of publication bias was low. Conclusions For DIPG patients who were treated with RT in conjunction with TMZ, the combined 1-year OS and 2-year OS were 43% and 11%. The pooled 1-year PFS and 2-year PFS were 20% and 2%. Requirements of up-to-date evidence on evaluating the prognostic impact of this therapy are urgent.