PMID- 25630625
OWN - NLM
STAT- MEDLINE
DCOM- 20151207
LR  - 20230919
IS  - 1573-7373 (Electronic)
IS  - 0167-594X (Print)
IS  - 0167-594X (Linking)
VI  - 122
IP  - 2
DP  - 2015 Apr
TI  - Survival outcomes and safety of carmustine wafers in the treatment of high-grade 
      gliomas: a meta-analysis.
PG  - 367-82
LID - 10.1007/s11060-015-1724-2 [doi]
AB  - Carmustine wafers (CW; Gliadel((R)) wafers) are approved to treat newly-diagnosed 
      high-grade glioma (HGG) and recurrent glioblastoma. Widespread use has been 
      limited for several reasons, including concern that their use may preclude 
      enrollment in subsequent clinical trials due to uncertainty about confounding of 
      results and potential toxicities. This meta-analysis estimated survival following 
      treatment with CW for HGG. A literature search identified relevant studies. 
      Overall survival (OS), median survival, and adverse events (AEs) were summarized. 
      Analysis of variance evaluated effects of treatment (CW vs non-CW) and diagnosis 
      (new vs recurrent) on median survival. The analysis included 62 publications, 
      which reported data for 60 studies (CW: n = 3,162; non-CW: n = 1,736). For 
      newly-diagnosed HGG, 1-year OS was 67 % with CW and 48 % without; 2-year OS was 
      26 and 15 %, respectively; median survival was 16.4 +/- 21.6 months and 13.1 +/- 29.9 
      months, respectively. For recurrent HGG, 1-year OS was 37 % with CW and 34 % 
      without; 2-year OS was 15 and 12 %, respectively; median survival was 9.7 +/- 20.9 
      months and 8.6 +/- 22.6 months, respectively. Effects of treatment (longer median 
      survival with CW than without; P = 0.043) and diagnosis (longer median survival 
      for newly-diagnosed HGG than recurrent; P < 0.001) on median survival were 
      significant, with no significant treatment-by-diagnosis interaction (P = 0.620). 
      The most common AE associated with wafer removal was surgical site infection 
      (SSI); the most common AEs for repeat surgery were mass effect, SSI, 
      hydrocephalus, cysts in resection cavity, acute hematoma, wound healing 
      complications, and brain necrosis. These data may be useful in the context of 
      utilizing CW in HGG management, and in designing future clinical trials to allow 
      CW-treated patients to participate in experimental protocols.
FAU - Chowdhary, Sajeel A
AU  - Chowdhary SA
AD  - Department of Neuro-Oncology, Florida Hospital Cancer Institute, 2501 N. Orange 
      Avenue, Suite 286, Orlando, FL, 32804, USA.
FAU - Ryken, Timothy
AU  - Ryken T
FAU - Newton, Herbert B
AU  - Newton HB
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20150129
PL  - United States
TA  - J Neurooncol
JT  - Journal of neuro-oncology
JID - 8309335
RN  - 0 (Antineoplastic Agents, Alkylating)
RN  - 0 (Decanoic Acids)
RN  - 0 (Drug Implants)
RN  - 0 (Polyesters)
RN  - 0 (carmustine, poliferprosan 20 drug combination)
RN  - U68WG3173Y (Carmustine)
SB  - IM
MH  - Antineoplastic Agents, Alkylating/adverse effects/*therapeutic use
MH  - Brain Neoplasms/*drug therapy/pathology
MH  - Carmustine/adverse effects/*therapeutic use
MH  - Decanoic Acids/adverse effects/*therapeutic use
MH  - Drug Implants/adverse effects/therapeutic use
MH  - Glioma/*drug therapy/pathology
MH  - Humans
MH  - Neoplasm Grading
MH  - Neoplasm Recurrence, Local/drug therapy/pathology
MH  - Polyesters/adverse effects/*therapeutic use
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC4368843
EDAT- 2015/01/30 06:00
MHDA- 2015/12/15 06:00
PMCR- 2015/01/29
CRDT- 2015/01/30 06:00
PHST- 2014/06/03 00:00 [received]
PHST- 2015/01/19 00:00 [accepted]
PHST- 2015/01/30 06:00 [entrez]
PHST- 2015/01/30 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
PHST- 2015/01/29 00:00 [pmc-release]
AID - 1724 [pii]
AID - 10.1007/s11060-015-1724-2 [doi]
PST - ppublish
SO  - J Neurooncol. 2015 Apr;122(2):367-82. doi: 10.1007/s11060-015-1724-2. Epub 2015 
      Jan 29.