title: Etoposide improves survival in high-grade glioma: a meta-analysis.
abstract: BACKGROUND
  The purpose of this meta-analysis was to evaluate the therapeutic efficacy of topoisomerase inhibitors in the treatment of high-grade gliomas (HGGs).
  
  
  METHODS
  Using median overall survival (mOS) and survival gain, we compared the efficacy of chemotherapy drugs in a meta-analysis of 624 HGG studies, including 44,850 patients from studies published between 1976 and 2011.
  
  
  RESULTS
  Patient cohorts treated with etoposide had significant improvement in mOS (15.66 months vs. 13.27 months, p=0.026, 49 vs. 795 cohorts) and significant survival gain advantage (p=0.022) over cohorts treated without etoposide. In contrast, patient cohorts treated with irinotecan had significantly worse mOS (10.20 vs. 13.55 months, p=0.008, 35 vs. 810 cohorts) and a disadvantage compared to cohorts treated without irinotecan in survival gain analysis.
  
  
  CONCLUSIONS
  Results from this analysis suggest that etoposide may improve overall survival for patients with HGG, whereas the use of irinotecan might result in inferior outcomes.
authors.affiliation: Children's National Medical Center, 111 Michigan Ave NW, Washington DC 20010, USA. aleonard@cnmc.org
authors.forename: Alexis
authors.initials: A
authors.lastname: Leonard
authors.forename: Johannes E
authors.initials: JE
authors.lastname: Wolff
mesh_terms: D001932:Brain Neoplasms / Q000188:drug therapy*; D015331:Cohort Studies; D003710:Demography; D005047:Etoposide / Q000627:therapeutic use*; D005260:Female; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D059003:Topoisomerase Inhibitors / Q000627:therapeutic use
chemical_list: D059003:Topoisomerase Inhibitors; D005047:Etoposide
keywords: Anaplastic; etoposide; glioblastoma multiforme; high-grade glioma; irinotecan; meta-analysis; teniposide; topotecan