QUESTION: What is the safety and efficacy of interstitial chemotherapy with @entity3600 -loaded polymers (Gliadel wafers: MGI Pharma, Bloomington, MN, U.S.A.) in the treatment of newly diagnosed or recurrent @entity11 (that is, @entity463 multiforme, @entity816 , @entity816 , and @entity3271 )? PERSPECTIVES: @entity11 is the most common type of primary @entity1313 in adults. In general, efficacy of systemic therapy in this @entity1 population has been disappointing, and novel treatment approaches are needed. Because several randomized controlled trials (RCTS) investigating the safety and efficacy of Gliadel are available, the Neuro-oncology Disease Site Group of @entity5 Care Ontario's Program in Evidence-Based Care decided that a systematic review of the evidence was necessary. OUTCOMES: The outcomes of interest for this review were overall survival, adverse events, and quality of life. METHODOLOGY: Systematic searches of the medline, embase, and Cochrane Library databases were conducted for relevant evidence. Fully-published reports of RCTS comparing treatment with Gliadel wafers to placebo or alternative treatment were selected for inclusion. Prospective cohort studies were also included. RESULTS: Two RCTS that compared Gliadel to placebo in @entity1 with newly diagnosed @entity11 were obtained. Both RCTS reported a significant survival benefit for @entity1 who received Gliadel as compared with @entity1 in the control group. One RCT and one prospective cohort study were obtained that examined the role of Gliadel in @entity1 with recurrent @entity11 . The rct demonstrated a significant survival benefit for Gliadel only after adjustment for prognostic factors, and the prospective cohort study reported no survival benefit for Gliadel as compared with a historical control group. All three RCTS reported similar rates of adverse events in the treatment and control groups. The most frequently reported adverse events were @entity410 , @entity911 , @entity2657 , @entity281 , @entity1269 , @entity2026 , and @entity227 . CONCLUSIONS: Gliadel is an option for selected @entity1 with newly diagnosed @entity11 where a near gross total resection is possible. No evidence is available comparing Gliadel with systemic therapy, and a decision to combine Gliadel with systemic therapy should be made for @entity1 individually. The @entity1 population that would benefit from Gliadel (age, histology, and performance status) is unclear; further investigation is needed. Gliadel is also an option for @entity1 with surgically resectable recurrent @entity11 .

Gliadel wafers in the treatment of XXXX : a systematic review.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity410 :: ('MESH:D012640', 'Disease') :: ['convulsions'] @entity227 :: ('MESH:D014786', 'Disease') :: ['visual field defects'] @entity2657 :: ('MESH:D001929', 'Disease') :: ['brain edema'] @entity1313 :: ('MESH:D001932', 'Disease') :: ['brain tumour'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer'] @entity1269 :: ('MESH:D010291', 'Disease') :: ['hemiparesis'] @entity11 :: ('MESH:D005910', 'Disease') :: ['malignant glioma', 'Malignant glioma'] @entity3600 :: ('MESH:D002330', 'Chemical') :: ['carmustine'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity2026 :: ('MESH:D001037', 'Disease') :: ['aphasia'] @entity816 :: ('MESH:D001254', 'Disease') :: ['anaplastic astrocytoma', 'anaplastic oligoastrocytoma'] @entity911 :: ('MESH:D003221', 'Disease') :: ['confusion'] @entity463 :: ('MESH:D005909', 'Disease') :: ['glioblastoma'] @entity3271 :: ('MESH:D009837', 'Disease') :: ['anaplastic oligodendroglioma']
@entity11 :: (MESH:D005910,Disease) :: ['malignant glioma']
