PLoS ONE (Jan 2017)

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

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

DOI
https://doi.org/10.1371/journal.pone.0180470
Journal volume & issue
Vol. 12, no. 7
p. e0180470

Abstract

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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. 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.