Kong Xiangyi, Guan Jian, Yang Yi, Li Yongning, Ma Wenbin, Wang Renzhi
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Hutong of Dongcheng District, Beijing 100730, PR China.
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Hutong of Dongcheng District, Beijing 100730, PR China.
Clin Neurol Neurosurg. 2015 Jul;134:98-103. doi: 10.1016/j.clineuro.2015.04.010. Epub 2015 Apr 18.
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.
A meta-analysis of randomized trials was conducted to estimate the effectiveness of seizure prophylaxis in people with brain tumors.
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.
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).
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.
癫痫发作是脑肿瘤潜在的严重并发症。过去有多项研究试图证明，脑肿瘤患者使用预防性抗癫痫药物（AEDs）可降低癫痫发作的发生率。然而，目前尚不清楚对于从未发生过癫痫发作的脑肿瘤患者是否应常规给予AEDs。
进行一项随机试验的荟萃分析，以评估脑肿瘤患者预防性抗癫痫治疗的有效性。
检索了一系列电子数据库（1966 - 2014年）：MEDLINE、Cochrane图书馆数据库、EMBASE、CINAHL、科学引文索引和中国生物医学数据库（CBM），无语言限制。两名独立的评审员评估试验的纳入资格和质量，并使用STATA 12.0软件进行荟萃分析。计算综合比值比（OR）及其相应的95%置信区间（95%CI）。
纳入6项随机对照试验，共547例脑肿瘤患者。荟萃分析结果显示，接受预防性抗癫痫干预的脑肿瘤患者癫痫发生率并不显著低于对照组（OR = 0.939，95%CI = 0.609 - 1.448，z = 0.29，P = 0.775）。敏感性分析表明统计结果稳健。该荟萃分析未检测到发表偏倚（P>0.05）。
尽管过去一些研究表明AEDs可用于脑肿瘤患者以缓解癫痫，但目前的综合证据尚不能明确表明脑肿瘤患者能从预防性抗癫痫治疗中获益。
