Tumor treating fields plus chemotherapy improved survival outcomes for newly diagnosed and recurrent glioblastoma patients in this meta-analysis

BackgroundThis systematic review and meta-analysis aimed to evaluate the efficacy and safety of tumor treating fields (TTF) combined with chemotherapy compared with chemotherapy alone in patients with newly diagnosed and recurrent glioblastoma (GBM).MethodA systematic search was conducted in PubMed, Embase, Web of Science, Cochrane Library, and databases from their inception to 10 December 2025. Randomized controlled trials, controlled clinical trials and observational cohort studies evaluating the efficacy and safety of TTF in GBM treatment were included. Evaluating the efficacy and safety of TTF in GBM treatment were included. Data were pooled using Stata 15 software.ResultsA total of 14 studies involving 2,376 patients (both newly diagnosed and recurrent GBM) were included: 7 RCTs, 4 CCTs, and 3 observational cohort studies were included. Pooled analyses demonstrated that compared with chemotherapy alone, TTF combined with chemotherapy significantly prolonged progression-free survival (PFS) (HR = 0.62, 95% CI: 0.55–0.69, P < 0.0001) and overall survival (OS) (HR = 0.63, 95% CI: 0.56–0.72, P < 0.0001) in both newly diagnosed and recurrent GBM patients. No significant difference in systemic adverse events was observed between the two groups (OR = 1.10, 95% CI: 0.79–1.53, P = 0.571); however, the incidence of skin irritation was significantly higher in the TTF group (OR = 12.87, 95% CI: 7.47–22.18, P < 0.0001). Subgroup analyses indicated that patient diagnosis type contributed to heterogeneity across studies.ConclusionIn newly diagnosed and recurrent GBM, TTF combined with chemotherapy significantly improves survival outcomes compared with chemotherapy alone, highlighting the therapeutic value and safety of the combined treatment in both patient populations.