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Survival outcomes and safety of carmustine wafers in the treatment of high-grade gliomas: a meta-analysis.

Al's Comment:

 The results for Gliadel wafer are impressive when you consider it is just a 1 time insertion of wafers. These wafers have been vastly underutilized at some brain tumor centers. The reason stated is usually that they would prevent you from entering some clinical trials but if you look at the history of clinical trials in the past, most did not result in a gain as good as Gliadel would have given.  The restriction on prior use of Gliadel wafer for clinical trials should be removed immediately. It is not ethical to withhold a known benefit. At the very least, it should be required to at least discuss the risks and benefits of Gliadel before any brain tumor surgery.

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