Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-ICO Duran i Reynals, Barcelona, Spain.
Expert Rev Clin Pharmacol. 2013 May;6(3):333-44. doi: 10.1586/ecp.13.12.
Glioblastoma-related epilepsy requires paying careful attention to a combination of factors with an integrated approach. Major interrelated issues must be considered in the seizure care of glioblastoma patients. Seizure control frequently requires the administration of antiepileptic drugs simultaneously with other treatments, including surgery, radiotherapy and chemotherapy, with complete seizure relief often being difficult to achieve. The pharmacological interactions between antiepileptic drugs and antineoplastic agents can modify the activity of both treatments, compromising their efficacy and increasing the probability of developing adverse events related to both therapies. This review summarizes the new pathophysiological pathways involved in the epileptogenesis of glioblastoma-related seizures and the interactions between antiepileptic drugs and oncological treatment, paying special attention to its impact on survival and the current evidence of the antiepileptic treatment efficacy, including the potential usefulness of new third-generation compounds.
胶质母细胞瘤相关性癫痫需要综合考虑多种因素并予以密切关注。在胶质母细胞瘤患者的癫痫治疗中，必须考虑到主要的相互关联的问题。抗癫痫药物的应用常需联合手术、放疗和化疗等其他治疗手段，以控制癫痫发作，但往往难以完全缓解癫痫。抗癫痫药物与抗肿瘤药物之间的药物相互作用可改变两种治疗方法的活性，从而降低其疗效，并增加与两种治疗方法相关的不良反应的发生概率。本综述总结了胶质母细胞瘤相关性癫痫发生的新病理生理学途径，以及抗癫痫药物与肿瘤治疗之间的相互作用，特别关注其对生存的影响，以及抗癫痫治疗疗效的现有证据，包括新型第三代化合物的潜在作用。
