AB083。癫痫与低级别胶质瘤手术切除后的癫痫控制：一项回顾性队列研究

IF 2.1 4区医学 Q3 ONCOLOGY

Chinese clinical oncology Pub Date : 2024-08-01 DOI:10.21037/cco-24-ab083

Saqib Kamran Bakhshi, Rabeet Tariq, Faiza Urooj, Safwan Masood, Farhan Arshad Mirza, Syed Ather Enam

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引用次数: 0

摘要

背景：癫痫发作是低级别胶质瘤患者（60%-75%）的常见表现，60%-90%的患者在切除后可摆脱癫痫发作。癫痫发作的控制因组织病理学、切除范围和发作类型而异。关于肿瘤切除术后抗癫痫药物（AEDs）的效用，文献报道并不一致。我们旨在确定低级别胶质瘤（LGG）切除术后患者癫痫发作控制的相关因素：这是一项回顾性队列研究。我们回顾了2019年至2021年在本中心接受低级别胶质瘤切除术的所有患者的病历，77名患者符合入选标准。研究人员还通过电话与患者取得联系，根据恩格尔分类法收集其癫痫发作控制情况的信息。数据使用 SPSSv21 进行分析：平均年龄为（34.9±11.3）岁，男性占多数（62；80.5%）。全身性发作是最常见的类型（54；70%），左乙拉西坦是最常用的抗癫痫药物（60；77.9%）。术前使用 AED 的中位时间为 4 个月[四分位距（IQR）：1-24]。额叶是最常见的肿瘤位置（36；46.8%）。大多数患者在全身麻醉下进行手术（51；61.4%），29（37.7%）名患者在清醒状态下进行开颅手术。近一半的患者进行了大体全切（31；40.3%），另有 15 人（19.5%）进行了近全切。16名患者（20.8%）在术后6个月内（间隔时间不定）停用了AED，随访时所有患者的恩格尔分级均为IA级至ID级（P=0.008）。12名I级胶质瘤患者的癫痫发作也得到了最佳控制（P=0.03）：结论：I级胶质瘤患者术后癫痫发作控制较好。肿瘤活检与较差的癫痫发作预后有关，但无统计学意义。需要进行更大规模的研究，以确定手术后停用 AED 的理想时间和患者群体。

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AB083. Epilepsy and low-grade glioma-seizure control after surgical resection: a retrospective cohort study.

Background: Seizures are a common manifestation in patients with low grade glioma (60-75%), and 60-90% patients attain seizure freedom after resection. Seizure control varies with histopathology, extent of resection and type of seizures. There is inconsistency in literature regarding utility of anti-epileptic drugs (AEDs) after tumor resection. We aimed to determine factors associated with seizure control in patients after low-grade glioma (LGG) resection.

Methods: It was a retrospective cohort study. Medical record of all patients who underwent LGG resection at our center from 2019 to 2021 were reviewed; 77 patients fulfilled the selection criteria. Patients were also contacted via phone calls to collect information about their seizure control as per Engel Classification. Data was analyzed using SPSSv21.

Results: The mean age was 34.9±11.3 years, and there was male predominance (62; 80.5%). Generalized seizures were the most common type (54; 70%), and Levetiracetam was the most commonly prescribed AED (60; 77.9%). The median duration of pre-operative AED use was 4 [interquartile range (IQR): 1-24] months. Frontal lobe was the most common location of tumor (36; 46.8%). Most of the patients had their surgery under general anesthesia (51; 61.4%), while 29 (37.7%) underwent awake craniotomy. Nearly half of the patients had a gross total resection (31; 40.3%), and another 15 (19.5%) had near-total resection. Sixteen patients (20.8%) had their AEDs stopped within first 6 months post-operatively (at variable intervals), and all of them had Engel Class IA to ID control at time of follow-up (P=0.008). The 12 patients with grade I glioma also had optimum seizure control (P=0.03).

Conclusions: Patients with grade I glioma have better seizure control after surgery. Tumor biopsy is associated with worse seizure outcome, though not statistically significant. Larger studies are needed to determine the ideal time and patient group for discontinuing AED after surgery.

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来源期刊

Chinese clinical oncology ONCOLOGY-

CiteScore

3.90

自引率

0.00%

发文量

期刊介绍： The Chinese Clinical Oncology (Print ISSN 2304-3865; Online ISSN 2304-3873; Chin Clin Oncol; CCO) publishes articles that describe new findings in the field of oncology, and provides current and practical information on diagnosis, prevention and clinical investigations of cancer. Specific areas of interest include, but are not limited to: multimodality therapy, biomarkers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to cancer. The aim of the Journal is to provide a forum for the dissemination of original research articles as well as review articles in all areas related to cancer. It is an international, peer-reviewed journal with a focus on cutting-edge findings in this rapidly changing field. To that end, Chin Clin Oncol is dedicated to translating the latest research developments into best multimodality practice. The journal features a distinguished editorial board, which brings together a team of highly experienced specialists in cancer treatment and research. The diverse experience of the board members allows our editorial panel to lend their expertise to a broad spectrum of cancer subjects.