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Research
Maher Kurdi
King Abdulaziz University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8979-3849
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: (a) To assess the control of glioblastoma-associated seizure in patients receiving different anti-epileptic drugs and chemotherapies after total resection and its association with O-methylguanine-DNA methyltransferase (MGMT) promotor methylation and the isocitrate dehydrogenase 1 (IDH1) mutation; (b) to determine which anti-epileptic drug exerts the best effective control on glioblastoma-associated epilepsy; (c) to identify the relationship between seizure control and different anti-epileptic drugs and recurrence interval.
Methods: This was a retrospective cohort study of patients with postoperative glioblastoma-associated epilepsy in the period between 2014 and 2019. The correlations between the IDH1 mutation and MGMT promotor methylation with anti-epileptic drugs, chemotherapy type, seizure control, and recurrence interval were analyzed using different statistical methods.
Results: This study included 53 adult patients with glioblastoma-associated epilepsy. The IDH1 mutation was present in 20 patients, and MGMT promotor methylation was present in 13 patients. Out of 53 patients, 37 cases received chemoradiotherapy while 16 cases receive only radiotherapy. Levetiracetam was the most prescribed anti-epileptic drug (n= 36, 60%), and 36 and 16 patients had controlled and uncontrolled seizures, respectively. The IDH1 mutation and unmethylated MGMT promotor were significantly present in cases with controlled epilepsy (P < 0.05). Among the anti-epileptic drugs, levetiracetam showed significantly better seizure control in cases with the IDH1 mutation and unmethylated MGMT promotor (P < 0.05). Patients did not show significant differences in either seizure control or the tumor recurrence interval (P > 0.05).
Conclusion: (a) Glioblastoma-associated epilepsy can be better controlled in patients with the IDH1 mutation and unmethylated MGMT promotor compared with patients with the methylated MGMT promotor, (b) Levetiracetam is considered the first-line anti-epileptic drug for controlling seizures but may not enhance the sensitivity of glioblastomas to chemotherapies, (c) Lack of seizure control in glioblastoma patients may not be related to tumor recurrence despite one-year treatment with anti-epileptic drugs, (d) Better understanding of the risk factors and mechanisms associated with glioma-associated epilepsy are needed to improve patient quality of life.
Keywords
Glioblastoma, Epilepsy, MGMT promotor methylation, IDH1 mutation, Anti-epileptic drugs, Temozolomide
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This is a preprint. It has not completed peer review.
Research
Maher Kurdi
King Abdulaziz University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8979-3849
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 Mar, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: (a) To assess the control of glioblastoma-associated seizure in patients receiving different anti-epileptic drugs and chemotherapies after total resection and its association with O-methylguanine-DNA methyltransferase (MGMT) promotor methylation and the isocitrate dehydrogenase 1 (IDH1) mutation; (b) to determine which anti-epileptic drug exerts the best effective control on glioblastoma-associated epilepsy; (c) to identify the relationship between seizure control and different anti-epileptic drugs and recurrence interval.
Methods: This was a retrospective cohort study of patients with postoperative glioblastoma-associated epilepsy in the period between 2014 and 2019. The correlations between the IDH1 mutation and MGMT promotor methylation with anti-epileptic drugs, chemotherapy type, seizure control, and recurrence interval were analyzed using different statistical methods.
Results: This study included 53 adult patients with glioblastoma-associated epilepsy. The IDH1 mutation was present in 20 patients, and MGMT promotor methylation was present in 13 patients. Out of 53 patients, 37 cases received chemoradiotherapy while 16 cases receive only radiotherapy. Levetiracetam was the most prescribed anti-epileptic drug (n= 36, 60%), and 36 and 16 patients had controlled and uncontrolled seizures, respectively. The IDH1 mutation and unmethylated MGMT promotor were significantly present in cases with controlled epilepsy (P < 0.05). Among the anti-epileptic drugs, levetiracetam showed significantly better seizure control in cases with the IDH1 mutation and unmethylated MGMT promotor (P < 0.05). Patients did not show significant differences in either seizure control or the tumor recurrence interval (P > 0.05).
Conclusion: (a) Glioblastoma-associated epilepsy can be better controlled in patients with the IDH1 mutation and unmethylated MGMT promotor compared with patients with the methylated MGMT promotor, (b) Levetiracetam is considered the first-line anti-epileptic drug for controlling seizures but may not enhance the sensitivity of glioblastomas to chemotherapies, (c) Lack of seizure control in glioblastoma patients may not be related to tumor recurrence despite one-year treatment with anti-epileptic drugs, (d) Better understanding of the risk factors and mechanisms associated with glioma-associated epilepsy are needed to improve patient quality of life.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
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