Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.
Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Cancer Med. 2021 May;10(9):2967-2977. doi: 10.1002/cam4.3868. Epub 2021 Mar 26.
Meningioma is the most common primary intracranial tumor and surgery is the main treatment modality. As death from lack of tumor control is rare, other outcome measures like anxiety, depression and post-operative epilepsy are becoming increasingly relevant. In this nationwide registry-based study we aimed to describe the use of antiepileptic drugs (AED), antidepressants and sedatives before and after surgical treatment of an intracranial meningioma compared to a control population, and to provide predictors for continued use of each drug-group two years after surgery.
All adult patients with histopathologically verified intracranial meningiomas were identified in the Swedish Brain Tumor Registry and their data were linked to relevant national registries after assigning five matched controls to each patient. We analyzed the prescription patterns of antiepileptic drugs (AED), antidepressants and sedative drugs in the two years before and the two years following surgery.
For the 2070 patients and 10312 controls identified the use of AED, antidepressants and sedatives was comparable two years before surgery. AED use at time of surgery was higher for patients than for controls (22.2% vs. 1.9%, p < 0.01), as was antidepressant use (12.9% vs. 9.4%, p < 0.01). Both AED and antidepressant use remained elevated after surgery, with patients having a higher AED use (19.7% vs. 2.3%, p < 0.01) and antidepressant use (14.8% vs. 10.6%, p < 0.01) at 2 years post-surgery. Use of sedatives peaked for patients at the time of surgery (14.4% vs. 6.1%, p < 0.01) and remained elevated at two years after surgery with 9.9% versus 6.6% (p < 0.01). For all the studied drugs, previous drug use was the strongest predictor for use 2 years after surgery.
This nationwide study shows that increased use of AED, antidepressants and sedatives in patients with meningioma started perioperatively, and remained elevated two years following surgery.
脑膜瘤是最常见的原发性颅内肿瘤，手术是主要的治疗方式。由于因肿瘤控制不佳而导致的死亡较为罕见，因此焦虑、抑郁和术后癫痫等其他结果指标变得越来越重要。在这项基于全国范围登记的研究中，我们旨在描述与对照人群相比，在接受颅内脑膜瘤手术治疗前后，抗癫痫药物（AED）、抗抑郁药和镇静剂的使用情况，并提供手术后两年继续使用每种药物的预测因素。
在瑞典脑肿瘤登记处确定了所有经组织病理学证实的颅内脑膜瘤成年患者，并在为每位患者分配 5 名匹配对照后，将其数据与相关国家登记处进行了链接。我们分析了手术前两年和手术后两年内 AED、抗抑郁药和镇静药物的处方模式。
在 2070 名患者和 10312 名对照者中，手术前两年 AED、抗抑郁药和镇静药物的使用情况相似。手术时患者 AED 的使用率高于对照者（22.2%比 1.9%，p<0.01），抗抑郁药的使用率也更高（12.9%比 9.4%，p<0.01）。手术后 AED 和抗抑郁药的使用仍居高不下，患者 AED 的使用率更高（19.7%比 2.3%，p<0.01），抗抑郁药的使用率也更高（14.8%比 10.6%，p<0.01）。手术时患者镇静剂的使用率最高（14.4%比 6.1%，p<0.01），手术后两年仍居高不下，为 9.9%比 6.6%（p<0.01）。对于所有研究的药物，先前的药物使用是手术后两年药物使用的最强预测因素。
这项全国性研究表明，脑膜瘤患者在围手术期开始使用 AED、抗抑郁药和镇静剂，并且在手术后两年内仍持续使用。
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