Meta-analysis Of The Efficacy Of Lomustine-temozolomide Combination Therapy In The Treatment Of Glioblastoma

Purpose:This study conducted a meta-analysis of the efficacy of temozolomide combined with lomustine in the treatment of glioblastoma(GBM),in order to objectively evaluate the efficacy and safety of temozolomide combined with lomustine in the treatment of GBM,and further provide reference for clinical treatment.Method:With keywords of GBM,temozolomide and lomustine,we searched pubmed,web of science and CNKI database,and collected all data before February 3,2023.According to the inclusion and exclusion criteria,two researchers independently conducted literature screening.The quality of literature was evaluated according to the quality evaluation criteria of case-control studies.Meta analysis was performed by R4.2.1 software,and the heterogeneity was evaluated by Q test and I~2statistics.P<0.05 or I~2>50%were regarded as statistical differences in the heterogeneity test.Result:According to the inclusion and exclusion criteria,the final 12 articles were included in the study.First,the therapeutic effect of temozolomide and lomustine alone on GBM patients was studied.The results showed that,based on the data of 322 patients included in the two studies,the treatment effect of lomustine was analyzed.The results showed that there was no significant effect in reducing the lesion volume(OR=1.15;95%CI[0.44,5.12])and delaying the disease progression(OR=0.97,95%CI[0.59,1.58]).Then,the data of 377 patients included in 7 studies of the effect of TMZ on GBM were analyzed.The results showed that temozolomide could significantly alleviate the patient’s condition(OR=2.31;95%CI[1.27,4.20])and reduce GBM disease progression(OR=0.27;95%CI[0.12,0.60]).Finally,the efficacy of the combination of temozolomide and lomustine was investigated.The results showed that the combination of temozolomide and lomustine could inhibit the progression of disease(OR=0.37;95%CI[0.15,0.91]),stabilize the condition of patients(OR=1.68;95%CI[0.67,4.18])and alleviate the condition of patients(OR=2.58;95%CI[0.75,8.95]).The analysis of publication bias showed that there was no publication bias in the results of this study(P>0.05).The sensitivity analysis further confirmed that the relevant conclusions of this study are stable and reliable.Conclusion:The combination of temozolomide and lomustine can significantly inhibit the disease progression of GBM patients,and is an effective method to treat GBM and prolong the survival rate of patients.