A meta-analysis: Do prophylactic antiepileptic drugs in patients with brain tumors decrease the incidence of seizures?

BACKGROUND

Seizures are a potentially devastating complication of brain tumors. Several studies in the past have attempted to demonstrate that prophylactic antiepileptic drugs (AEDs) in patients with brain tumors can decrease the incidence of seizures. However, it is currently unclear whether AEDs should be routinely administered to patients with brain tumors who have never had a seizure.

OBJECTIVE

A meta-analysis of randomized trials was conducted to estimate the effectiveness of seizure prophylaxis in people with brain tumors.

METHODS

A range of electronic databases were searched (1966-2014): MEDLINE, the Cochrane Library Database, EMBASE, CINAHL, Web of Science and the Chinese Biomedical Database (CBM) without language restrictions. Two independent reviewers assessed trials for eligibility and quality, and meta-analysis was performed using the STATA 12.0 software. Integrated Odd Ratio (OR) with its corresponding 95% confidence interval (95%CI) was calculated.

RESULTS

Six RCTs were included with a total of 547 patients with brain tumors. The meta-analysis results revealed that patients with brain tumors who received prophylactic antiepileptic interventions did not have significantly lower epilepsy incidence than those in controlled groups (OR=0.939, 95%CI=0.609-1.448, z=0.29, P=0.775). Sensitivity analysis suggested the statistical results were robust. No publication bias was detected in this meta-analysis (P>0.05).

CONCLUSION

Although some past studies indicated AEDs can be used in patients with brain tumors to relieve epilepsy, present integrated evidences cannot show in unequivocal terms that brain tumor patients can benefit from seizure prophylaxis.