Department of Neurosurgery, University of California San Diego, La Jolla, CA, 92103, USA.
Division of Pediatric Neurology, University of California, San Diego, La Jolla, CA, 92103, USA.
J Neurooncol. 2017 Nov;135(2):229-235. doi: 10.1007/s11060-017-2584-8. Epub 2017 Jul 28.
Glioblastoma is the most common form of primary brain cancer in adults and one of the deadliest of human cancers. Seizures are one of the most frequent presentations of glioblastoma. The use of anti-epileptic drugs (AEDs) in glioblastoma patients suffering from seizures is well accepted. However, the role of long-term AED use in patients with glioblastoma without a history of seizures is controversial. Here, we performed a review of the literature to identify studies that examined the use of AEDs in seizure-free glioblastoma patients. We identified one randomized controlled study suggesting no clinical benefit of seizure prophylaxis in this population. Three of the four retrospective studies identified in our search recapitulated this finding, while the remaining study suggested a benefit for prophylactic AED use. All identified studies were focused on seizure incidence in the post-operative period, ranging from 1 week to long-term follow up. Implications of these findings are reviewed herein.
胶质母细胞瘤是成人中最常见的原发性脑癌，也是人类癌症中最致命的癌症之一。癫痫发作是胶质母细胞瘤最常见的表现之一。在患有癫痫发作的胶质母细胞瘤患者中使用抗癫痫药物（AEDs）是被广泛接受的。然而，长期使用 AED 治疗无癫痫发作史的胶质母细胞瘤患者的作用仍存在争议。在这里，我们对文献进行了回顾，以确定研究检查了 AED 在无癫痫发作的胶质母细胞瘤患者中的使用情况。我们确定了一项随机对照研究表明，在该人群中预防性使用 AED 没有临床获益。我们在搜索中确定的四项回顾性研究中有三项重现了这一发现，而其余的研究则表明预防性使用 AED 有获益。所有确定的研究都集中在术后期间的癫痫发作发生率，从 1 周到长期随访不等。本文回顾了这些发现的意义。
