Brain Tumors Unit, Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia.
Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 318, Bogotá, Colombia.
J Neurooncol. 2018 Jan;136(2):363-371. doi: 10.1007/s11060-017-2660-0. Epub 2017 Nov 25.
Epilepsy is a common symptom in patients with glioblastoma (GB). 213 patients with GB from RedLANO follow-up registry were included. All patients underwent surgery, if feasible, followed by chemoradiation based on temozolomide (Stupp platform). Information was recorded regarding demographics, seizure timing, anti-epileptic drugs (AEDs), dosage, time to next seizure, total seizures in 6 months, and main side effects of AEDs. The relationship between epilepsy treatment and overall survival (OS) was evaluated. Mean age was 53 years old and 56.8% were male. Seventy-eight patients (37%) were treated with levetiracetam (LEV), 27% were given another AED and 36% did not require any AED. Choice of AED was not associated with age (p = 0.67), performance status (p = 0.24) or anatomic tumor site (p = 0.34). Seizures and AED requirement were greater in those having primary GB (p = 0.04). After starting an AED, the mean time until next crisis was 9.9 days (SD ± 6.3), which was shorter in those receiving LEV (p = 0.03); mean number of seizures during the first 3 and 6 months were 2.9 and 4, respectively. Most patients treated with LEV (n = 46) required less than two medication adjustments compared to those treated with other AEDs (p = 0.02). Likewise, less patients exposed to LEV required a coadjuvant drug (p = 0.04). Additionally, patients receiving LEV had significantly less adverse effects compared to patients treated with another AED. OS was significantly higher in the group treated with LEV compared to other AEDs (25.5 vs. 17.9 months; p = 0.047). Patients treated with LEV had better seizure control and longer OS compared to other AEDs.
癫痫是胶质母细胞瘤(GB)患者的常见症状。本研究纳入了来自 RedLANO 随访登记处的 213 名 GB 患者。所有患者均接受了手术,如果可行,随后根据替莫唑胺(Stupp 平台)进行放化疗。记录了患者的人口统计学资料、癫痫发作时间、抗癫痫药物(AED)、剂量、下一次癫痫发作时间、6 个月内总癫痫发作次数以及 AED 的主要副作用。评估了癫痫治疗与总生存期(OS)的关系。患者平均年龄为 53 岁,56.8%为男性。78 例(37%)患者接受左乙拉西坦(LEV)治疗,27%给予另一种 AED,36%无需任何 AED。AED 的选择与年龄(p=0.67)、表现状态(p=0.24)或解剖肿瘤部位(p=0.34)无关。原发性 GB 患者的癫痫发作和 AED 需求更大(p=0.04)。开始使用 AED 后,下一次危机的平均时间为 9.9 天(SD ±6.3),接受 LEV 治疗的患者更短(p=0.03);第 1、3 和 6 个月的平均癫痫发作次数分别为 2.9 和 4。与接受其他 AED 治疗的患者相比,接受 LEV 治疗的患者(n=46)需要调整药物的次数少于 2 次(p=0.02)。同样,接受 LEV 治疗的患者需要辅助药物的比例更少(p=0.04)。此外,与接受另一种 AED 治疗的患者相比,接受 LEV 治疗的患者不良反应明显更少。与接受其他 AED 治疗的患者相比,接受 LEV 治疗的患者 OS 明显更高(25.5 个月比 17.9 个月;p=0.047)。与其他 AED 相比,接受 LEV 治疗的患者癫痫发作控制更好,OS 更长。