Table 2.
Summary of seizure outcome after chemotherapy
| Article | Study Design | Population (baseline) | Treatment | Additional Treatment, n | Time of Seizure Assessment | Seizure Outcome (% total population) |
|---|---|---|---|---|---|---|
| Mason et al, 199622 | Prospective | Newly diagnosed and recurrent LGG 9 (6 with epilepsy) | PCV | Resection: 5/9 (56%) | N/S | Improved seizure control: 6/6 (100%) |
| Soffietti et al, 199842 | Prospective | Progressive LGG 26 (23 with epilepsy and/or neurological deficits): OA 9/O 17 |
PCV | Resection: 23/26 (88%) Radiotherapy: 11/26 (42%) |
At 4-wk intervals during chemotherapy | Improved seizure control: 7/23 (30%) Seizure freedom: 3/23 (13%) |
| Brada et al, 200336 | Prospective | Stable or progressive LGG 30 (27 with history of epilepsy): A 17/OA 2/O 11 |
TMZ | Resection: 12/30 (40%) | During chemotherapy (24 patients completed 12 cycles) | Improvement in seizure frequency: 14/27 (52%) |
| Pace et al, 200341 | Prospective | Progressive LGG 43 (31 with uncontrolled epilepsy): A 29/OA 4/O 10 |
TMZ | Resection: 32/43 (74%) Radiotherapy: 30 (70%) PCV: 16 (37%) |
Every 3 TMZ cycles | ≥50% Seizure reduction: 15/31 (48%) Seizure freedom: 4/31 (13%) (In patients with previously uncontrolled epilepsy) |
| Hoang-Xuan et al, 200438 | Prospective | Progressive LGG 60: O 49/OA 11 (seizure status unknown) |
TMZ | Resection: 27/60 (45%) | N/S | Neurological improvement (eg, a reduction in seizure frequency): 30/59 (51%) |
| Biemond-ter Stege et al, 200534 | Retrospective | O and OA, newly diagnosed or recurrent 21 (20 with epilepsy) | PCV | Radiotherapy: 5/21 (24%) | N/S | Improved seizure control in most of 16 patients showing radiological response to treatment |
| Frenay et al, 200537 | Retrospective | A 10 (9 with epilepsy; 8 with pharmacoresistant epilepsy) | PCV/F-C-E | None | After 2nd course | Seizure reduction: 100% Seizure freedom: 60% |
| Kaloshi et al, 200723 | Retrospective | Progressive LGG 149: O 105/A-OA 44 (seizure status unknown) |
TMZ | Resection: 68/149 (46%) | Unknown; general follow-up: 30.4 m (range 2–70 m) | ≥50% Seizure reduction: 87/149 (58%) |
| Lebrun et al, 200739 | Retrospective | O 33 (24 with epilepsy at tumor presentation) | PCV | Resection: 7/33 (21%) | During chemotherapy (mean of 5 courses) | Seizure reduction: 53% Seizure freedom: 31% |
| Tosoni et al, 200824 | Prospective | Recurrent or progressive LGG 30 (13 with intractable seizures): A 9/OA 3/O 18 |
TMZ | Resection: 20/30 (67%) | After beginning of TMZ treatment | Seizure frequency reduction: 8/13 (62%) |
| Taillandier et al, 200943 | Retrospective | Insular LGG 21 (20 with epilepsy): A 3/OA 1/O 15/LGG N/S 2 | TMZ/PCV/F | Resection: 5/21 (24%) | N/S | Improved Engel class: 16/20 (80%) Seizure freedom: 8/20 (40%) |
| Blonski et al, 201235 | Prospective | Unresectable LGG and seizure at tumor presentation 10: A 2/OA 2/O 6 |
Neoadjuvant TMZ | Resection 3/10 (30%) | N/S | Seizure frequency reduction: 9/10 (90%) Seizure freedom: 5/10 (50%) |
| Sherman et al, 201112 | Retrospective | (1) LGG and seizure at tumor presentation 39 (12 patients seizure free with AED): A 3/OA 11/O 22/LGG N/S 3 (2) LGG controls with seizure at presentation 30 (14 patients seizure free with AED) |
TMZ Observation |
Resection: 24/39 (62%) Resection: 13/30 (43%) |
After median of 7 TMZ cycles N/S |
≥50% Seizure reduction: 23/39 (59%) ≥50% Seizure reduction without AED changes: 7/39 (18%) ≥50% Seizure reduction: 4/30 (13%) ≥50% Seizure reduction without AED changes: 0 |
| Koekkoek et al, 201440 | Retrospective | 66 LGG patients with uncontrolled epilepsy: A 43/OA 9/O 14 |
TMZ | Resection: 37/66 (56%) Radiotherapy: 46/66 (70%) |
After 6 m | ≥50% Seizure reduction without AED changes: 29/66 (44%) Seizure freedom: 27/66 (41%) |
Abbreviations: A, astrocytoma grade II; OA, oligoastrocytoma grade II; O, oligodendroglioma grade II; PCV, procarbazine, lomustine, and vincristine; F, fotemustine; C, cisplatin; E, etoposide; N/S, not specified; m, months.