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Antiepileptic drug prophylaxis in primary brain tumor patients: is current practice in agreement to the consensus?

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Abstract

The role of antiepileptic drugs (AED) prophylaxis in primary brain tumor (PBT) seizure-naïve patients remains unclear. Additionally, AED are associated with severe side effects, negative impact on cognition and drug interactions. Little is known about current practice regarding prophylactic AED use in PBT. We investigated its use in a tertiary care cancer center. We reviewed medical records of 260 patients registered in our center between 2008 and 2012, focusing on prophylactic AED use. A descriptive analysis was performed with SPSS IBM version 20.0. Median age was 44.5 years (11–83). Most patients had ECOG PS ≤1 (76.4 %). Among 141 seizure-naïve patients, 70.2 % received an AED as primary prophylaxis (PP). Most commonly used drugs as PP were phenytoin (85.9 %), carbamazepine (6.1 %) and phenobarbital (5.1 %). In only 14 patients (14.1 %) AEDs were eventually discontinued, in a median time of 5.9 months (1.1–76.8 m). AED were used as PP in 60 % of low-grade gliomas, 73.3 % of anaplastic gliomas and 93.9 % of glioblastoma patients. Twenty-seven patients (27.3 %) on PP presented seizures, generally associated with tumor progression. Of the 42 seizure-naïve patients not receiving AED prophylaxis, only two presented seizures, which occurred during or within the first week post-radiotherapy. In this cross-sectional study, prophylactic AED use in PBT was extremely high. Postoperatively, AED were discontinued in a minority of patients, mostly after a prolonged period. Current prophylactic AED use patterns in PBT are not in accordance with established guidelines.

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Ethical standards statement

I hereby declare that the experiments of our study, entitled “ANTIEPILEPTIC DRUG PROPHYLAXIS IN PRIMARY BRAIN TUMOR PATIENTS: IS CURRENT PRACTICE IN AGREEMENT TO THE CONSENSUS?”, were approved by the local ethics research committee and comply with the current laws of the country in which they were performed.

Conflict of interest

I hereby declare that none of the authors of this paper bear any kind of conflict of interests regarding the subject of our study entitled “ANTIEPILEPTIC DRUG PROPHYLAXIS IN PRIMARY BRAIN TUMOR PATIENTS: IS CURRENT PRACTICE IN AGREEMENT TO THE CONSENSUS?”

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Authors and Affiliations

  1. Divisionof Medical Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Arnaldo 251, 5º andar, São Paulo, SP, 01246-000, Brazil

    Julia Andrade de Oliveira, Iuri A. Santana, Inacelli Q. S. Caires, Rafael Caires-Lima, Vanessa Costa Miranda, Bruno M. Protásio, Lucila S. Rocha, Henrique F. Braga, Ana M. Mencarini & Olavo Feher

  2. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Ovídio Pires de Campos, 225, São Paulo, SP, 05403-010, Brazil

    Manoel Jacobsen Teixeira & Luiz Henrique Martins Castro

Authors
  1. Julia Andrade de Oliveira
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  2. Iuri A. Santana
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  3. Inacelli Q. S. Caires
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  4. Rafael Caires-Lima
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  5. Vanessa Costa Miranda
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  6. Bruno M. Protásio
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  7. Lucila S. Rocha
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  8. Henrique F. Braga
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  9. Ana M. Mencarini
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  10. Manoel Jacobsen Teixeira
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  11. Luiz Henrique Martins Castro
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  12. Olavo Feher
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Corresponding author

Correspondence to Olavo Feher.

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de Oliveira, J.A., Santana, I.A., Caires, I.Q.S. et al. Antiepileptic drug prophylaxis in primary brain tumor patients: is current practice in agreement to the consensus?. J Neurooncol 120, 399–403 (2014). https://doi.org/10.1007/s11060-014-1564-5

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  • DOI: https://doi.org/10.1007/s11060-014-1564-5

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