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. 2021 Jun 25;25(1):108-113.
doi: 10.29337/ijsp.148.

Global Landscape of Glioblastoma Multiforme Management in the Stupp Protocol Era: Systematic Review Protocol

Gideon Adegboyega  1   2 , Ulrick Sidney Kanmounye  2 , Tatjana Petrinic  3 , Ahmad Ozair  4 , Soham Bandyopadhyay  5 , Ashvin Kuri  1 , Yvan Zolo  2   6 , Katya Marks  7 , Serena Ramjee  1 , Ronnie E Baticulon  8   9 , Babar Vaqas  10   11 ; InciSion UK Collaborative
Affiliations

Global Landscape of Glioblastoma Multiforme Management in the Stupp Protocol Era: Systematic Review Protocol

Gideon Adegboyega et al. Int J Surg Protoc. .

Abstract

Background: Glioblastoma multiforme is the most common and aggressive primary adult brain neoplasm. The current standard of care is maximal safe surgical resection, radiotherapy with concomitant temozolomide, followed by adjuvant temozolomide according to the Stupp protocol. Although the protocol is well adopted in high-income countries (HICs), little is known about its adoption in low- and middle-income countries (LMICs). The aim of this study is to describe a protocol design for a systematic review of published studies outlining the differences in GBM management between HICs and LMICs.

Methods: A systematic review will be conducted. MedLine via Ovid, Embase and Global Index Medicus will be searched from inception to date in order to identify the relevant studies. Adult patients (>18 years) with histologically confirmed primary unifocal GBM will be included. Surgical and chemoradiation management of GBM tumours will be considered. Commentaries, original research, non-peer reviewed pieces, opinion pieces, editorials and case reports will be included.

Results: Primary outcomes will include rates of complications, disability-adjusted life years (DALYs), prognosis, progression-free survival (PFS), overall survival (OS) as well as rate of care abandonment and delay. Secondary outcomes will include the presence of neuro-oncology subspecialty training programs.

Discussion: This systematic review will be the first to compare the current landscape of GBM management in HICs and LMICs, highlighting pertinent themes that may be used to optimise treatment in both financial brackets.

Systematic review registration: The protocol has been registered on the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020215843).

Highlights: Glioblastoma multiforme (GBM) remains the most common primary adult cerebral neoplasm, with an age-adjusted incidence rate of 3.22 per 100,000 population and a 5-year survival rate of 6.8%Despite the well-evidenced efficacy of Stupp protocol, the implementation of this approach bears an institutional and individual financial burden that is particularly notable in low- and middle-income countries (LMICs)This systematic review will be the first to compare the current landscape of GBM management in HICs and LMICs, highlighting pertinent themes that may be used to optimise treatment in both financial brackets.

Keywords: glioblastoma multiforme; global neurosurgery; healthcare disparities; low and middle income countries; neuro-oncology; systematic review protocol.

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Conflict of interest statement

The authors have no competing interests to declare.

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References

    1. Ostrom QT, Cioffi G, Gittleman H, et al. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012–2016. Neuro Oncol. 11 2019; 21(Suppl 5): v1–v100. DOI: 10.1093/neuonc/noz150 - DOI - PMC - PubMed
    1. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. March 2005; 352(10): 987–96. DOI: 10.1056/NEJMoa043330 - DOI - PubMed
    1. Walker MD, Alexander E, Hunt WE, et al. Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg. September 1978; 49(3): 333–43. DOI: 10.3171/jns.1978.49.3.0333 - DOI - PubMed
    1. Walker MD, Green SB, Byar DP, et al. Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med. December 1980; 303(23): 1323–9. DOI: 10.1056/NEJM198012043032303 - DOI - PubMed
    1. Sarwar MR, Iftikhar S, Saqib A. Availability of anticancer medicines in public and private sectors, and their affordability by low, middle and high-income class patients in Pakistan. BMC Cancer. 01 2018; 18(1): 14. DOI: 10.1186/s12885-017-3980-3 - DOI - PMC - PubMed