Journal Article

Patterns of care of brain tumor-related epilepsy. A cohort study done in Italian Epilepsy Center

Beghi, Ettore, Pauletto, Giada, Terenzi, Riccardo, Paladin, Francesco, Ricci, Federica, Prato, Giulia, Maschio, Marta, Buttinelli, Carla, Saladini, Marina, Vigevano, Federico, Rossi, Rosario, Aguglia, Umberto, Avanzini, Giuliano, Daniele, Ornella, Colicchio, Gabriella, Casazza, Marina M. L., Monti, Fabrizio, Quadri, Stefano, Striano, Salvatore, Aloisi, Paolo, Banfi, Paola, Zanoni, Tiziano, Casellato, Susanna, Crichiutti, Giovanni, Giannarelli, Diana, De Simone, Roberto, Costa, Cinzia, Giallonardo, Anna Teresa, Salmaggi, Andrea

2017

Overview

Epilepsy is the most common comorbidity in patients with brain tumors. To define characteristics of brain tumor-related epilepsy (BTRE) patients and identify patterns of care. Nationwide, multicenter retrospective cohort study. Medical records of BTRE patients seen from 1/1/2010 to 12/31/2011, followed for at least one month were examined. Information included age, sex, tumor type/treatments, epilepsy characteristics, antiepileptic drugs (AEDs). Time to modify first AED due to inefficacy and/or toxicity was assessed with the Kaplan-Meier method and Cox proportional hazard models were used to identify predictors of treatment outcome. Enrolled were 808 patients (447 men, 361 women) from 26 epilepsy centers. Follow-up ranged 1 to 423 months (median 18 months). 732 patients underwent surgery, 483 chemotherapy (CT), 508 radiotherapy. All patients were treated with AEDs. Levetiracetam was the most common drug. 377 patients (46.7%) were still on first drug at end of follow-up, 338 (41.8%) needed treatment modifications (uncontrolled seizures, 229; side effects, 101; poor compliance, 22). Treatment discontinuation for lack of efficacy was associated with younger age, chemotherapy, and center with <20 cases. Treatment discontinuation for side effects was associated with female sex, enzyme-inducing drugs and center with > 20 cases. About one-half of patients with BTRE were on first AED at end of follow-up. Levetiracetam was the most common drug. A non enzyme-inducing AED was followed by a lower risk of drug discontinuation for SE.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Analysis / Angiogenesis / Anticonvulsants - therapeutic use / Antiepileptic agents / Biology and Life Sciences / Brain / Brain cancer / Brain Neoplasms - complications / Brain tumors / Care and treatment / Chemotherapy / Cohort analysis / Complications and side effects / Convulsions & seizures / Diagnosis / Drugs / Enzymes / Epilepsy / Epilepsy - complications / Epilepsy - drug therapy / Etiracetam / Female / Humans / Italy / Male / Medical records / Medicine and Health Sciences / Patient Care - statistics & numerical data / Patients / Psychological aspects / Quality control / Radiation therapy / Retrospective Studies / Risk / Risk factors / Seizures / Sex / Side effects / Surgery / Survival Analysis / Toxicity / Treatment Outcome / Tumors