Background: This study aimed to assess the relative efficacy of modern radiotherapy strategies in patients with newly diagnosed glioblastoma. Method: A comprehensive literature review was conducted through MEDLINE, Embase and the Cochrane Central Registry of Controlled Trials of studies focused on newly diagnosed glioblastoma published up to and counting 15 September 2022. We included randomized controlled trials (RCTs) and comparative nonrandomized studies (NRSs) of radiotherapy for newly diagnosed glioblastoma. Eligible studies included patients treated with three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, volumetric modulated arc therapy or proton therapy reporting either overall survival, progression-free survival or both. The impact of different radiotherapy modalities on survival was evaluated by direct comparisons of indirect evidence and estimated hazard ratios in terms of a Bayesian network meta-analysis. Results: A total of six RCTs or NRSs comprising 816 glioblastoma patients with modern radiotherapy strategies were reviewed, yielding improved overall survival by proton therapy over all other regimens. The network meta-analysis also indicated a significant advantage of proton therapy compared with other radiotherapy strategies in regard to progression-free survival. Conclusion: Our findings suggested PT as a standard RT regime with possibly superior survival outcomes for selected patients with GBM.
背景：本研究旨在评估现代放疗策略对新诊断胶质母细胞瘤患者的相对疗效。方法：通过检索截至2022年9月15日的MEDLINE、Embase及Cochrane对照试验中心注册库，对已发表的针对新诊断胶质母细胞瘤的研究进行全面文献回顾。我们纳入了针对新诊断胶质母细胞瘤放疗的随机对照试验及非随机对照比较研究。符合条件的研究需包含接受三维适形放疗、调强放疗、容积旋转调强放疗或质子治疗的患者，并报告总生存期、无进展生存期或两者兼具。通过直接比较间接证据及贝叶斯网络荟萃分析估算风险比，评估不同放疗模式对生存期的影响。结果：共纳入6项随机对照试验或非随机对照研究，涉及816例接受现代放疗策略的胶质母细胞瘤患者，分析显示质子治疗在所有治疗方案中具有更优的总生存期。网络荟萃分析同时表明，在无进展生存期方面，质子治疗相较于其他放疗策略具有显著优势。结论：本研究提示质子治疗可作为标准放疗方案，可能为特定胶质母细胞瘤患者带来更优的生存结局。
肿瘤(癌症)患者之家