Role of antiseizure medication in postoperative late seizure and survival among patients with newly diagnosed glioblastoma: A multicenter retrospective study.
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Inoue Akihiro, Ohno Makoto, Nakamura Yawara, Narita Yoshitaka, Kawauchi Daisuke, Shimoda Yoshiteru, Hanihara Mitsuto, Matsutani Tomoo, Ohba Shigeo, Yamashita Natsumi, Sugii Narushi, Saito Kuniaki, Shibahara Ichiyo, Takayanagi Shunsaku, Ishida Joji, Takahashi Masamichi, Kijima Noriyuki, Mitobe Yuta, Higa Nayuta, Saito Masato, Matsuda Ryosuke, Ishi Yukitomo, Nakajima Kohei, Yamashita Shinji, Tamura Kaoru, Ozono Iori, Setoguchi Taiki, Negoto Tetsuya, Katayama Kosuke, Kambe Atsushi, Kuga Daisuke, Tanaka Kazuhiro, Okuda Takeshi, Sumi Koichiro, Kanda Takahiro, Takada Shigeki, Wada Kojiro, Fujii Yu, Kawanishi Yu, Arita Hideyuki, Sato Yuichi, Yonemochi Takuya, Otani Ryohei, Koizumi Shinichiro, Arakawa Yoshiki, Kunieda Takeharu
Аннотация
METHODS: 1132 consecutive patients with newly diagnosed glioblastoma at 39 centers were enrolled. In patients treated with postoperative ASM (levetiracetam [LEV], lacosamide [LCM], or perampanel [PER]), as well as in those who received no medication, the cumulative incidence of late seizure, adverse events, and survival outcomes were analyzed.
RESULTS: In total, 1099 patients (female: 482, male: 617, mean age: 67.2 years) were included, among whom, 287 developed postoperative late seizure. The mean onset time of late seizure was 193.6 days after surgery. Postoperative ASMs were administered in 628 cases, LEV in 344, LCM in 124, and PER in 160. The cumulative incidence of late seizure at 12 months was as follows: no medication in 30.9%, LEV in 17.8%, LCM in 28.8%, and PER in 16.2%. Multivariable analysis disclosed that LEV and PER displayed significantly lower cumulative incidences of postoperative late seizure compared with no medication and LCM. By contrast, median progression-free survival/overall survival did not significantly differ among ASMs. However, during the 12-24 month interval, the PER group demonstrated a more favorable prognosis than the other groups.
CONCLUSIONS: LEV and PER after glioblastoma surgery were associated with a reduced risk of late seizure compared with LCM or no medication. LEV or PER may be considered as postoperative ASMs to optimize seizure control and potentially help preserve patients' QOL.