PDF(Pubmed)
Abstract：
UNASSIGNED: There are no clear indications for the best choice of anti-seizure medications to control brain tumor related epilepsy. In vitro studies have shown an antitumoral effect of Levetiracetam and Lacosamide on glioblastoma IDH-wild type.
UNASSIGNED: This study investigates whether the use of levetiracetam and/or lacosamide impacts survival rates. The secondary aim was to evaluate the efficacy of both ASMs in controlling seizures.
UNASSIGNED: In this observational retrospective single-cohort study, patients underwent chemoradiation protocol after GBM surgery. They were grouped as follows: (1) use of levetiracetam, (2) use of lacosamide, (3) simultaneous use of levetiracetam and lacosamide, (4) no ASM usage. Survival curves were plotted using the Kaplan-Meier method coupled with a log-rank test for difference assesments. To evaluate the pharmacological efficacy of post-operative seizure control, a negative binomial regression was conducted.
UNASSIGNED: The study included 272 patients, 174 of which underwent adjuvant chemoradiation treatment. Patients without ASM therapy had a non-significant longer median OS (compared to the other groups (log-rank = 0.37). The IRR of seizure relapse was 2.57 (p = 0.007) times higher in lacosamide users, and MGMT promoter methylation demonstrated a protective effect against postoperative seizure onset (p = 0.05), regardless of the aforementioned confounding factors.
UNASSIGNED: In patients diagnosed with GBM IDH-WT undergoing chemoradiation therapy, the use of levetiracetam or lacosamide for controlling BTRE does not seem to modify survival. Lacosamide users exhibited a higher IRR of postoperative seizures compared to levetiracetam users, and MGMT promoter methylation appears to be a protective factor.
UNASSIGNED: This study investigates whether the use of levetiracetam and/or lacosamide impacts survival rates. The secondary aim was to evaluate the efficacy of both ASMs in controlling seizures.
UNASSIGNED: In this observational retrospective single-cohort study, patients underwent chemoradiation protocol after GBM surgery. They were grouped as follows: (1) use of levetiracetam, (2) use of lacosamide, (3) simultaneous use of levetiracetam and lacosamide, (4) no ASM usage. Survival curves were plotted using the Kaplan-Meier method coupled with a log-rank test for difference assesments. To evaluate the pharmacological efficacy of post-operative seizure control, a negative binomial regression was conducted.
UNASSIGNED: The study included 272 patients, 174 of which underwent adjuvant chemoradiation treatment. Patients without ASM therapy had a non-significant longer median OS (compared to the other groups (log-rank = 0.37). The IRR of seizure relapse was 2.57 (p = 0.007) times higher in lacosamide users, and MGMT promoter methylation demonstrated a protective effect against postoperative seizure onset (p = 0.05), regardless of the aforementioned confounding factors.
UNASSIGNED: In patients diagnosed with GBM IDH-WT undergoing chemoradiation therapy, the use of levetiracetam or lacosamide for controlling BTRE does not seem to modify survival. Lacosamide users exhibited a higher IRR of postoperative seizures compared to levetiracetam users, and MGMT promoter methylation appears to be a protective factor.
摘要：
■没有明确的适应症可以选择最佳的抗癫痫药物来控制脑肿瘤相关的癫痫。体外研究显示左乙拉西坦和拉科酰胺对野生型成胶质细胞瘤的抗肿瘤作用。
■本研究调查了使用左乙拉西坦和/或拉科沙胺是否会影响生存率。次要目的是评估两种ASM控制癫痫发作的功效。
■在这项观察性回顾性单队列研究中，患者在GBM手术后接受放化疗方案。它们被分组如下：(1)使用左乙拉西坦，（2）使用拉科沙胺，（3）同时使用左乙拉西坦和拉科沙胺，（4）没有ASM使用。使用Kaplan-Meier方法绘制生存曲线，并进行对数秩检验以进行差异评估。评估术后癫痫发作控制的药理作用，进行负二项回归。
■该研究包括272名患者，其中174例接受了辅助放化疗治疗。未接受ASM治疗的患者的中位OS无明显延长（与其他组相比（log-rank=0.37）。拉科沙胺使用者癫痫发作复发的IRR为2.57(p=0.007)倍，MGMT启动子甲基化显示了对术后癫痫发作的保护作用（p=0.05），不考虑上述混杂因素。
■在接受放化疗治疗的GBMIDH-WT患者中，使用左乙拉西坦或拉科沙胺控制BTRE似乎不会改变生存率.与左乙拉西坦使用者相比，Lacosamide使用者表现出更高的术后癫痫发作IRR，MGMT启动子甲基化似乎是一种保护因素。
■本研究调查了使用左乙拉西坦和/或拉科沙胺是否会影响生存率。次要目的是评估两种ASM控制癫痫发作的功效。
■在这项观察性回顾性单队列研究中，患者在GBM手术后接受放化疗方案。它们被分组如下：(1)使用左乙拉西坦，（2）使用拉科沙胺，（3）同时使用左乙拉西坦和拉科沙胺，（4）没有ASM使用。使用Kaplan-Meier方法绘制生存曲线，并进行对数秩检验以进行差异评估。评估术后癫痫发作控制的药理作用，进行负二项回归。
■该研究包括272名患者，其中174例接受了辅助放化疗治疗。未接受ASM治疗的患者的中位OS无明显延长（与其他组相比（log-rank=0.37）。拉科沙胺使用者癫痫发作复发的IRR为2.57(p=0.007)倍，MGMT启动子甲基化显示了对术后癫痫发作的保护作用（p=0.05），不考虑上述混杂因素。
■在接受放化疗治疗的GBMIDH-WT患者中，使用左乙拉西坦或拉科沙胺控制BTRE似乎不会改变生存率.与左乙拉西坦使用者相比，Lacosamide使用者表现出更高的术后癫痫发作IRR，MGMT启动子甲基化似乎是一种保护因素。
