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 VigevanoRoberto De Simone, Federica Ricci, Marina Saladini, Fabrizio Monti, Susanna Casellato, Tiziano Zanoni, Diana Giannarelli, Giuliano Avanzini, Umberto Aguglia

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Abstract

Epilepsy is the most common comorbidity in patients with brain tumors. Study Aims: 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.
Original languageEnglish
Pages (from-to)e0180470
JournalPLoS One
Volume12
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

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    Maschio, M., Beghi, E., Casazza, M. M. L., Colicchio, G., Costa, C., Banfi, P., Quadri, S., Aloisi, P., Teresa Giallonardo, A., Buttinelli, C., Pauletto, G., Striano, S., Salmaggi, A., Terenzi, R., Daniele, O., Crichiutti, G., Paladin, F., Rossi, R., Prato, G., ... Aguglia, U. (2017). Patterns of care of brain tumor-related epilepsy. A cohort study done in Italian Epilepsy Center. PLoS One, 12(7), e0180470. https://doi.org/10.1371/journal.pone.0180470