Article
Potential effect of levetiracetam on survival of patients with glioblastoma multiforme
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Authors
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Jorge Humberto Tapia-Pérez
- Universitätsklinik für Neurochirurgie, Otto von Guericke-Universität; Magdeburg, Germany
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Katharina Groehl
- Universitätsklinik für Neurochirurgie, Otto von Guericke-Universität; Magdeburg, Germany
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Benjamin Voellger
- Klinik für Neurochirurgie, Philipps-Universität; Marburg, Germany
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Thomas Schneider
- Universitätsklinik für Neurochirurgie, Otto von Guericke-Universität; Magdeburg, Germany
| Published: | June 2, 2015 |
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Outline
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Objective: Glioblastoma multifome (GBM) is the most common malignant brain tumor in adults. The positive effect of valproate acid on survival among patients with GBM has been reported. For newer antiepileptic drugs (AED) such as levetiracetam (LEV) no clinical data exists, while results from in vitro experiments suggest an anti-tumor effect of LEV. Our study analyzes whether LEV use in patients with GBM delays tumor progression or prolongs the overall survival.
Method: We included in this study 84 patients with histologically confirmed GBM that underwent radiotherapy or radiochemotherapy with temozolomide after tumor resection. Overall survival at 24 months (OS-24), progression-free survival at 12 months (PFS-12) and Karnofsky Performance Status Score at 12 months (KPSS-12) were recorded. Pearson's correlation coefficients were calculated for LEV dosage versus PFS-12 and LEV dosage versus KPSS-12. Kaplan Meier curves were fitted for OS-24 PFS-12.
Results: 43 patients were taking an AED at the time of diagnosis. The most common used AED was LEV (n=27). No relevant difference in clinical characteristics was found between treatment groups. At 24 months, 48 deaths were observed. Positive correlations of LEV dosage with PFS-12 (r=0.86) were observed. Kaplan Meier curves demonstrated a borderline significant difference in OS-24 (22/43 AED-users deceased, while 26/41 non-users deceased; Log Rank p=0.06). After comparison of LEV users versus non-users of AED, the same trend was observed (13/27 LEV-users deceased and 26/41 non-users deceased; Log Rank p=0.06). No significant difference in PFS-12 was detected.
Conclusions: Our data suggest that AED, particularly LEV, might influence the course of patients with GBM. Post-hoc analysis of the clinical trials of GBM and randomized controlled trials are warranted to provide additional information.
