Koekkoek Johan A F, Kerkhof Melissa, Dirven Linda, Heimans Jan J, Reijneveld Jaap C, Taphoorn Martin J B
Department of Neurology, VU University Medical Center, Amsterdam, Netherlands (J.A.F.K., L.D., J.J.H., J.C.R., M.J.B.T.); Department of Neurology, Medical Center Haaglanden, The Hague, Netherlands (J.A.F.K., M.K., M.J.B.T.).
Neuro Oncol. 2015 Jul;17(7):924-34. doi: 10.1093/neuonc/nov032. Epub 2015 Mar 25.
There is growing evidence that antitumor treatment contributes to better seizure control in low-grade glioma patients. We performed a systematic review of the current literature on seizure outcome after radiotherapy and chemotherapy and evaluated the association between seizure outcome and radiological response. Twenty-four studies were available, of which 10 described seizure outcome after radiotherapy and 14 after chemotherapy. All studies demonstrated improvements in seizure outcome after antitumor treatment. Eight studies reporting on imaging response in relation to seizure outcome showed a seizure reduction in a substantial part of patients with stable disease on MRI. Seizure reduction may therefore be the only noticeable effect of antitumor treatment. Our findings demonstrate the clinical relevance of monitoring seizure outcome after radiotherapy and chemotherapy, as well as the potential role of seizure reduction as a complementary marker of tumor response in low-grade glioma patients.
越来越多的证据表明，抗肿瘤治疗有助于更好地控制低级别胶质瘤患者的癫痫发作。我们对当前关于放疗和化疗后癫痫发作结果的文献进行了系统综述，并评估了癫痫发作结果与放射学反应之间的关联。共有24项研究，其中10项描述了放疗后的癫痫发作结果，14项描述了化疗后的癫痫发作结果。所有研究均表明抗肿瘤治疗后癫痫发作结果有所改善。8项报告影像反应与癫痫发作结果关系的研究显示，在MRI上疾病稳定的大部分患者中癫痫发作减少。因此，癫痫发作减少可能是抗肿瘤治疗唯一显著的效果。我们的研究结果证明了监测放疗和化疗后癫痫发作结果的临床相关性，以及癫痫发作减少作为低级别胶质瘤患者肿瘤反应补充标志物的潜在作用。
