Skip to main content
SpringerLink
Log in

Quality of life and seizure control in patients with brain tumor-related epilepsy treated with levetiracetam monotherapy: preliminary data of an open-label study

  • Brief Communication
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

The aim of this pilot study was to investigate the effects of levetiracetam monotherapy on seizure control, quality of life and neurocognitive performance in patients with brain tumor-related epilepsy. We present here preliminary data from 18 patients with follow-up of 6 months. We evaluated seizure frequency at baseline. We used administered Mini Mental State Examination (MMSE), Karnofsky Performance Status (KPS), Barthel index (BI), QOLIE 31P (V2), EORTC QLQ-C30 and Adverse Events Profile. After 6 months, 16 patients were seizure free (88.9%), 2 (11.1%) had reduction in seizure frequency >50%. Compared to baseline, we observed a worsening of performance (KPS p = 0.011; BI = 0.008) and global lower cognitive performance (MMSE p = 0.011); distress related to seizure frequency (p = 0.003) and medication effects (p = 0.046) were significantly lower. Levetiracetam caused mild and reversible side effects. These preliminary data on LEV monotherapy in patients with brain tumor-related epilepsy show that this antiepileptic drug is efficacious and well tolerated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Edvardsson T, Ahlström G (2005) Illness-related problems and coping among persons with low-grade glioma. Psychooncology 14:728–737

    Article  PubMed  Google Scholar 

  2. Klein M, Heimans JJ, Aaronson NK et al (2002) Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low grade gliomas: a comparative study. Lancet 360:1361–1368

    Article  PubMed  CAS  Google Scholar 

  3. Mainio A, Hakko H, Timonen M, Niemelä A, Koivukangas J, Räsänen P (2005) Depression in relation to survival among neurosurgical patients with a primary brain tumor: a 5-year follow-up study. Neurosurgery 56:1234–1241

    Article  PubMed  Google Scholar 

  4. Lynam LM, Lyons MK, Drazkowski JF, Sirven JI, Noe KH, Zimmerman RS, Wilkens JA (2007) Frequency of seizures in patients with newly diagnosed brain tumors: a retrospective review. Clin Neurol Neurosurg 109:634–638

    Article  PubMed  Google Scholar 

  5. van Breemen MS, Wilms EB, Vecht CJ (2007) Epilepsy in patients with brain tumors: epidemiology, mechanisms, and management. Lancet Neurol 6:421–430

    Article  PubMed  Google Scholar 

  6. Maschio M, Albani F, Baruzzi A et al (2006) Levetiracetam therapy in patients with brain tumor and epilepsy. J Neurooncol 80:97–100

    Article  PubMed  CAS  Google Scholar 

  7. Klein M, Engelberts NH, van der Ploeg HM et al (2003) Epilepsy in low-grade gliomas: the impact on cognitive function and quality of life. Ann Neurol 54:514–520

    Article  PubMed  Google Scholar 

  8. Glantz MJ, Cole BF, Forsyth PA et al (2000) Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Neurology 54:1886–1893

    PubMed  CAS  Google Scholar 

  9. Oberndorfer S, Piribauer M, Marosi C, Lahrmann H, Hitzenberger P, Grisold W (2005) P450 enzyme inducing and non-enzyme inducing antiepileptics in glioblastoma patients treated with standard chemotherapy. J Neurooncol 72:255–260

    Article  PubMed  CAS  Google Scholar 

  10. Contin M, Albani F, Riva R, Baruzzi A (2004) Levetiracetam therapeutic monitoring in patients with epilepsy: effect of concomitant antiepileptic drugs. Ther Drug Monit 26:375–379

    Article  PubMed  CAS  Google Scholar 

  11. Maschio M, Dinapoli L, Zarabla A, Jandolo B (2006) Issues related to the pharmacological management of patients with brain tumors and epilepsy. Funct Neurol 21:15–19

    PubMed  Google Scholar 

  12. Newton HB, Goldlust SA, Pearl D (2006) Retrospective analysis of the efficacy and tolerability of levetiracetam in brain tumor patients. J Neurooncol 78:99–102

    Article  PubMed  CAS  Google Scholar 

  13. Cancer Therapy Evaluation Program, Common Terminology Criteria for Adverse Events v3.0, DCTD, NCI, NIH, DHHS. http://ctep.cancer.gov. Accessed 12 December 2003

  14. Apolone G, Filiberti A, Cifani S, Ruggiata R, Mosconi P (1998) Evaluation of the EORTC QLQ-C30 questionnaire: a comparison with SF-36 Health Survey in a cohort of Italian long-survival cancer patients. Ann Oncol 9:549–557

    Article  PubMed  CAS  Google Scholar 

  15. Cramer JA, Van Hammée G, N132 Study Group (2003) Maintenance of improvement in health-related quality of life during long-term treatment with levetiracetam. Epilepsy Behav 4:118–123

    Article  PubMed  Google Scholar 

  16. Gilliam FG, Fessler AJ, Baker G, Vahle V, Carter J, Attarian H (2004) Systematic screening allows reduction of adverse antiepileptic drug effects: a randomized trial. Neurology 62:23–27

    PubMed  CAS  Google Scholar 

  17. Brown PD, Buckner JC, O’Fallon JR et al (2003) Effects of radiotherapy on cognitive function in patients with low-grade glioma measured by the folstein mini-mental state examination. J Clin Oncol 21:2519–2524

    Article  PubMed  Google Scholar 

  18. Karnofsky DA, Burchenal JH, Armistead GC, Southam CM, Bernstein JL, Craver LF, Rhoads CP (1951) Triethylene melamine in the treatment of neoplastic disease. Arch Int Med 87:477–516

    CAS  Google Scholar 

  19. Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel Index. Md State Med J 14:61–65

    PubMed  CAS  Google Scholar 

  20. Beaumont A, Whittle IR (2000) The pathogenesis of tumor associated epilepsy. Acta Neurochir 142:1–15

    Article  CAS  Google Scholar 

  21. Baltes S, Gastens AM, Fedrowitz M, Potschka H, Kaever V, Löscher W (2007) Differences in the transport of the antiepileptic drugs phenytoin, levetiracetam and carbamazepine by human and mouse P-glycoprotein. Neuropharmacology 52:333–346

    Article  PubMed  CAS  Google Scholar 

  22. Brada M, Viviers L, Abson C et al (2003) Phase II study of primary temozolomide chemotherapy in patients with WHO grade II gliomas. Ann Oncol 14:1715–1721

    Article  PubMed  CAS  Google Scholar 

  23. Perucca E, Meador KJ (2005) Adverse effects of antiepileptic drugs. Acta Neurol Scand Suppl 181:30–35

    Article  PubMed  CAS  Google Scholar 

  24. Meyers CA, Hess KR (2003) Multifaceted end points in brain tumor clinical trials: cognitive deterioration precedes MRI progression. Neuro Oncol 5:89–95

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to express their gratitude to Prof. Holger J. Schünemann for his precious help in writing the manuscript. This research was supported by UCB Pharma.

Conflict of interest statement

The authors have reported no conflicts of interest. The funding organization had no role in the design and conduct of the study, collection, management, analysis or interpretation of data, or in preparation of this manuscript. The funding organization has not reviewed this manuscript.

Author information

Authors and Affiliations

  1. Department of Neuroscience and Cervical-Facial Pathology, Center for Tumor-Related Epilepsy, National Institute for Cancer ‘Regina Elena’, Via Elio Chianesi 53, 00144, Rome, Italy

    Loredana Dinapoli, Marta Maschio & Bruno Jandolo

  2. Department of Oncology, National Institute for Cancer ‘Regina Elena’, Via Elio Chianesi 53, 00144, Rome, Italy

    Alessandra Fabi

  3. Department of Neuroscience and Cervical-Facial Pathology, National Institute for Cancer ‘Regina Elena’, Rome, Italy

    Andrea Pace

  4. S.C. Epidemiology, National Institute for Cancer ‘Regina Elena’, Via Elio Chianesi 53, 00144, Rome, Italy

    Francesca Sperati

  5. Scientific Direction, National Institute for Cancer ‘Regina Elena’, Via Elio Chianesi 53, 00144, Rome, Italy

    Paola Muti

Authors
  1. Loredana Dinapoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marta Maschio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bruno Jandolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alessandra Fabi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrea Pace
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Francesca Sperati
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Paola Muti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marta Maschio.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dinapoli, L., Maschio, M., Jandolo, B. et al. Quality of life and seizure control in patients with brain tumor-related epilepsy treated with levetiracetam monotherapy: preliminary data of an open-label study. Neurol Sci 30, 353–359 (2009). https://doi.org/10.1007/s10072-009-0087-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-009-0087-x

Keywords

Search

Navigation