Clinical Analysis for Brain Tumor-Related Epilepsy during Chemotherapy for Systemic Cancer with Single Brain Metastasis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose The purpose of this prospective observational study was to determine the incidence, patterns,and predisposing factors for brain tumor-related epilepsy (BTRE) during chemotherapy for systemic cancer with single brain metastasis (BM). Materials and Methods Between February 2006 and June 2010, 103 patients who underwent chemotherapy for systemic cancer with single BM were enrolled. We compared the clinical factors of patients and BM between patients with and without BTRE. We determined the number of patients with BTRE attacks, and seizure-free survival according to the following comparative groups:presence vs. absence of a history of BTRE; high-risk vs. low-risk groups; and presence vs. absence of disease-progression of BM. Results Ninety-three of 103 patients (90.3%) remained seizure-free during chemotherapy. The seizure-free rates were 88.9% and 91.0% among patients with or without a history of BTRE,respectively (p=0.694), 87.8%and 92.6%among high- and low-risk patients (p=0.427), respectively,and 62.5%and 98.7%among patients with or without disease-progression of BM (p=0.001),retrospectively. Based on multivariate analysis, the significance of abnormal findings on electroencephalogram (EEG) (p=0.017), and the absence of disease-progression of BM (p=0.001)had an association with seizure-free survival. Conclusion The significance of abnormal findings on EEG, and disease-progression of BM play important roles in the development of BTRE during chemotherapy for systemic cancer with BM.
Abstract
Purpose The purpose of this prospective observational study was to determine the incidence, patterns,and predisposing factors for brain tumor-related epilepsy (BTRE) during chemotherapy for systemic cancer with single brain metastasis (BM). Materials and Methods Between February 2006 and June 2010, 103 patients who underwent chemotherapy for systemic cancer with single BM were enrolled. We compared the clinical factors of patients and BM between patients with and without BTRE. We determined the number of patients with BTRE attacks, and seizure-free survival according to the following comparative groups:presence vs. absence of a history of BTRE; high-risk vs. low-risk groups; and presence vs. absence of disease-progression of BM. Results Ninety-three of 103 patients (90.3%) remained seizure-free during chemotherapy. The seizure-free rates were 88.9% and 91.0% among patients with or without a history of BTRE,respectively (p=0.694), 87.8%and 92.6%among high- and low-risk patients (p=0.427), respectively,and 62.5%and 98.7%among patients with or without disease-progression of BM (p=0.001),retrospectively. Based on multivariate analysis, the significance of abnormal findings on electroencephalogram (EEG) (p=0.017), and the absence of disease-progression of BM (p=0.001)had an association with seizure-free survival. Conclusion The significance of abnormal findings on EEG, and disease-progression of BM play important roles in the development of BTRE during chemotherapy for systemic cancer with BM.
참고문헌 (23)
- Herman ST, "Epilepsy after brain insult: targeting epileptogenesis", Neurology, 59(9), pp.S21~S26 (2002)
- Hauser WA, "Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935-1984", Epilepsia, 34, pp.453~468 (1993)
- Glantz MJ, "Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Report of the Quality Standards Subcommittee of the American Academy of Neurology", Neurology, 54, pp.1886~1893 (2000)
- Wen PY, "Medical management of patients with brain tumors", Curr Opin Oncol, 14, pp.299~307 (2002)
- Vertosick FT Jr, "Survival of patients with well-differentiated astrocytomas diagnosed in the era of computed tomography", Neurosurgery, 28, pp.496~501 (1991)
- Scott GM, "Epilepsy and other factors in the prognosis of gliomas", Acta Neurol Scand, 61, pp.227~239 (1980)
- Lieu AS, "Intracranial meningiomas and epilepsy: incidence, prognosis and influencing factors", Epilepsy Res, 38, pp.45~52 (2000)
- Hochberg FH, "Primary central nervous system lymphoma", J Neurosurg, 68, pp.835~853 (1988)
- Posner JB, "Management of brain metastases", Rev Neurol, 148, pp.477~487 (1992)
- DeAngelis LM, "Brain tumors", N Engl J Med, 344, pp.114~123 (2001)
- Schaller B, "Brain tumor and seizures: pathophysiology and its implications for treatment revisited", Epilepsia, 44, pp.1223~1232 (2003)
- Moots PL, "The course of seizure disorders in patients with malignant gliomas", Arch Neurol, 52, pp.717~724 (1995)
- Mason WP, "Anticonvulsant prophylaxis for patients with brain tumours: insights from clinical trials", Can J Neurol Sci, 30, pp.89~90 (2003)
- Bialer M, "Pharmacokinetic interactions of topiramate", Clin Pharmacokinet, 43, pp.763~780 (2004)
- Nuwer MR, "IFCN guidelines for topographic and frequency analysis of EEGs and EPs. The International Federation of Clinical Neurophysiology", Electroencephalogr Clin Neurophysiol Suppl, 52, pp.15~20 (1999)
- Folstein MF, "Mini-mental state : a practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
- Karnofsky DA, "The use of the nitrogen mustards in the palliative treatment of carcinoma: with particular reference to bronchogenic carcinoma", Cancer, 1, pp.634~656 (1948)
- "Proposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy", Epilepsia, 22, pp.489~501 (1981)
- (2006)[URL]
- Beaumont A, "The pathogenesis of tumour associated epilepsy", Acta Neurochir, 142, pp.1~15 (2000)
- Macleod M, "The effect of tumour associated epilepsy on performance", handicap scales used in cerebral glioma, 1995, pp.9, 653~657
- Wagner GL, "Levetiracetam: preliminary experience in patients with primary brain tumours", Seizure, 12, pp.585~586 (2003)
- Newton HB, "Retrospective analysis of the efficacy and tolerability of levetiracetam in brain tumor patients", J Neurooncol, 78, pp.99~10 (2006)
