抗惊厥药物对行放疗的 GBM 脑肿瘤患者生存的影响：一项 SEER-Medicare 分析。
The effect of anticonvulsants on survival among patients with GBM brain tumors undergoing radiation: A SEER-Medicare analysis.
机构信息
Departments of Radiation Oncology and Biostatics, USA.
University of Arkansas for Medical Sciences, Little Rock, AR, 72205, United States of America (MP, MB, FX), USA.
出版信息
J Clin Neurosci. 2022 Dec;106:32-36. doi: 10.1016/j.jocn.2022.09.019. Epub 2022 Oct 17.
BACKGROUND
Patients with glioblastoma multiforme (GBM) who undergo radiation often require anticonvulsants during treatment. The aim of this study was to determine the effects of anticonvulsants on GBM clinical outcomes.
METHODS
A retrospective analysis was performed using the SEER-Medicare database. All patients with GBM who were treated with radiation and concurrently taking an anticonvulsant were included in final analysis. Each class of medication was further subdivided by mechanism of action. Descriptive statistics were performed for all variables. Kaplan Meier survival curves were generated for each class of medication and Cox regression analysis was performed to assess the effect of each individual variable on survival.
RESULTS
There were 1561 patients available for final analysis. On multivariate Cox regression analysis, GBM patients taking sodium/calcium (Na/Ca) channel blocker anticonvulsants during radiation therapy demonstrated both improved overall survival (OS) (HR, 0.799; 95% CI [0.716, 0.891]; P < 0.001) and cancer specific survival (CSS) (HR, 0.814; 95% CI [0.727, 0.911]; P < 0.001).
CONCLUSION
OS was significantly better in patients taking NA/Ca channel blockers among patients with GBM who were concurrently undergoing radiation therapy.
背景
接受放射治疗的多形性胶质母细胞瘤 (GBM) 患者在治疗过程中通常需要使用抗癫痫药物。本研究旨在确定抗癫痫药物对 GBM 临床结局的影响。
方法
使用 SEER-Medicare 数据库进行回顾性分析。所有接受放射治疗并同时服用抗癫痫药物的 GBM 患者均纳入最终分析。根据作用机制进一步细分每种药物类别。对所有变量进行描述性统计。为每种药物类别生成 Kaplan-Meier 生存曲线，并进行 Cox 回归分析以评估每个个体变量对生存的影响。
结果
共有 1561 例患者可用于最终分析。多变量 Cox 回归分析显示，接受放射治疗期间服用钠/钙 (Na/Ca) 通道阻滞剂抗癫痫药物的 GBM 患者的总生存期 (OS)（HR，0.799；95%CI [0.716, 0.891]；P < 0.001）和癌症特异性生存期 (CSS)（HR，0.814；95%CI [0.727, 0.911]；P < 0.001）均得到改善。
结论
在同时接受放射治疗的 GBM 患者中，服用 Na/Ca 通道阻滞剂的患者 OS 明显更好。
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