Highlight: Glioblastoma is the most prevalent and deadly primary malignant brain tumor. The prognosis for glioblastoma remains unfavorable because of detrimental prognostic factors. Appropriate and advanced treatment can help in improving the survival rate of patients with glioblastoma. ABSTRACT Introduction: Glioblastoma is one of the deadly malignant brain tumor associated with a highly unfavorable prognosis, making it one of the significant challenge for clinicas due to its unfavorable poor prognostic. Patients with glioblastomas may experience headaches, nausea, vomiting, loss of consciousness, seizure/convulsion, altered mental status, and focal neurological deficits. Chemotherapy, radiation, and surgical resection became standar therapeutic options for patient with glioblastoma. This advanced treatment is important for increasing the survival rate of patients. Objective: This study aimed to evaluate survival outcomes in patients with glioblastoma treated with temozolomide plus radiotherapy compared with radiotherapy alone Methods: This study followed PRISMA guidelines and used the PICO framework. The inclusion criteria encompassed a range of study designs, including randomized controlled trials (RCTs), quasi-experimental, observational, and case-control studies, that evaluated survival outcomes in glioblastoma patients treated with radiotherapy plus 6 cycles of adjuvant temozolomide versus radiotherapy alone. Exclusion criteria eliminated studies that were not relevant to the comparative treatment approach. Results: Following three stages of screening, six articles that were directly relevant to the systematic review were selected for full-text analysis. Overall, radiotherapy plus temozolomide had better outcomes than radiotherapy alone. Median overall survival (OS) ranged from 10 to 17.5 months in patients with radiotherapy plus temozolomide, compared with 8 to 14 months in those treated with radiotherapy alone. Median progression-free survival (PFS) ranged from 6 to 10.1 months in patients with radiotherapy plus temozolomide, and 3.8 treated with radiotherapy alone. Conclusion: Diagnosing NPH remains challenging due to the overlap of its cognitive impairment symptoms with other neurocognitive disorders. Furthermore treatment response vary widely, makin it difficult for clinicians to effectively manage NPH patients. Although early and prompt diagnosis is crucial for successful therapy, clinician still face significant challenge.
Billy et al. (Sat,) studied this question.