Recurrent Pilocytic Astrocytoma
Budget: $30 – $250 USD
I am doing a systematic review and meta-analysis on 29 studies reporting outcomes following treatment for recurrent pilocytic astrocytoma. 25 of the 29 studies have individual patient level data. Data included include year of study, authors, number of patients, how many were male and how many were female, mean or median age, location of tumor, size of tumor (if available), initial treatment (resection vs radiation), extent of resection if had resection, adjuvant therapy before recurrence (radiotherapy and/or chemotherapy), type of radiotherapy, type of chemotherapy, time to recurrence, location of recurrence (local or leptomeningeal), malignant transformation, main second treatment (medical, surgery, or radiation), extent of resection for second surgery, adjuvant therapy after recurrence, most recent follow-up in months, vital status at most recent follow up (alive or dead), and radiographic outcome at most recent follow up (stable or recurrence).
In total, 105 cases are analyzed.
There may not be enough radiotherapy patients to make a true comparison. A more valuable analysis would include looking at the outcomes of these patients with smaller comparisons based on initial therapy, presentation, salvage therapy, and malignant transformation.
Possible analysis include the following:
Overall cohort—forest overall mortality, forest overall survival after recurrence, and forest overall malignant transformation.
To see how recurrence differs between the initial treatment groups and patient presentations—kaplan-meier, cox, compare subtotal resection versus gross total resection, compare locations of tumors, and possibly compare initial adjuvant versus no adjuvant.
To see how survival differs between initial treatment groups and patient presentations—kaplan-meier, cox, compare STR versus GTR, compare locations of tumors, and possibly compare initial adjuvant versus no adjuvant
To see how survival differs between treatments of recurrence—kaplan-meier, cox, compare surgery versus no surgery., compare extent of resection, and compare adjuvant versus no adjuvant therapy.
Finally, I want to analyze how malignant transformation alter survival.
In total, 105 cases are analyzed.
There may not be enough radiotherapy patients to make a true comparison. A more valuable analysis would include looking at the outcomes of these patients with smaller comparisons based on initial therapy, presentation, salvage therapy, and malignant transformation.
Possible analysis include the following:
Overall cohort—forest overall mortality, forest overall survival after recurrence, and forest overall malignant transformation.
To see how recurrence differs between the initial treatment groups and patient presentations—kaplan-meier, cox, compare subtotal resection versus gross total resection, compare locations of tumors, and possibly compare initial adjuvant versus no adjuvant.
To see how survival differs between initial treatment groups and patient presentations—kaplan-meier, cox, compare STR versus GTR, compare locations of tumors, and possibly compare initial adjuvant versus no adjuvant
To see how survival differs between treatments of recurrence—kaplan-meier, cox, compare surgery versus no surgery., compare extent of resection, and compare adjuvant versus no adjuvant therapy.
Finally, I want to analyze how malignant transformation alter survival.