Abstract

Purpose

Brain tumor-related epilepsy (BTRE) is frequent in patients affected with glioma. Most patients have refractory seizures and require polytherapy. Promising treatment options derive from the development of novel anti-epileptic drugs (AEDs), like Eslicarbazepine (ESL), whose role in BTRE has not yet been explored. Our aim was to report a retrospective cohort of patients affected by BTRE treated with ESL as an adjunctive therapy and to discuss the potential role of this third-generation AED in this clinical context.

Methods

We analyzed a single-center, retrospectively collected cohort of patients affected by glioma and BTRE, treated with ESL as an adjunctive therapy.

Results

Analysis included 5 males and 3 females with age ranging from 37 to 75 years (mean = 55.5). Mean baseline Karnofsky performance status was 87.5 (range 70–100). Patients were affected by diffuse astrocytoma (3), low grade oligodendroglioma (2), anaplastic glioma (2) and glioblastoma (1). Mean follow-up was 19 months (range 6–59). Mean dose at the last follow-up was 950 mg daily. Mean weekly seizures in the month before initiation of ESL numbered 17.6 (range 0.25–50). At the last follow-up, mean weekly seizures were 2.2 (range 0–10), i.e. significantly lower than baseline (p = 0.03). The mean reduction of seizures achieved after introduction of ESL was 65%, with 6/8 patients (75%) showing a reduction of more than 50%. Two patients (25%) were seizure free.

Conclusions

This single-center experience suggests that ESL may be a well-tolerated, efficacious option as an add-on drug in the treatment of BTRE.

中文翻译：

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艾司利卡西平治疗脑肿瘤相关癫痫患者的单中心经验

摘要

目的

脑肿瘤相关性癫痫 (BTRE) 在患有神经胶质瘤的患者中很常见。大多数患者有难治性癫痫发作，需要综合治疗。有希望的治疗选择源于新型抗癫痫药物 (AED) 的开发，例如 Eslicarbazepine (ESL)，其在 BTRE 中的作用尚未得到探索。我们的目的是报告一个受 BTRE 影响的患者的回顾性队列，这些患者使用 ESL 作为辅助治疗，并讨论这种第三代 AED 在这种临床背景下的潜在作用。

方法

我们分析了一个单中心、回顾性收集的受胶质瘤和 BTRE 影响的患者队列，这些患者接受 ESL 作为辅助治疗。

结果

分析包括 5 名男性和 3 名女性，年龄在 37 至 75 岁之间（平均值 = 55.5）。平均基线 Karnofsky 体能状态为 87.5（范围 70-100）。患者受到弥漫性星形细胞瘤 (3)、低级别少突胶质细胞瘤 (2)、间变性胶质瘤 (2) 和胶质母细胞瘤 (1) 的影响。平均随访时间为 19 个月（范围 6-59）。最后一次随访时的平均剂量为每天 950 毫克。ESL 开始前一个月的平均每周癫痫发作次数为 17.6（范围 0.25-50）。在最后一次随访时，平均每周癫痫发作为 2.2（范围 0-10），即显着低于基线（p  = 0.03）。引入 ESL 后癫痫发作的平均减少率为 65%，其中 6/8 名患者 (75%) 的减少超过 50%。两名患者 (25%) 没有癫痫发作。

结论

这一单中心经验表明，ESL 可能是一种耐受性良好、有效的选择，作为治疗 BTRE 的附加药物。