scholarly journals Prescription preferences of antiepileptic drugs in brain tumor patients: an international survey among EANO members

2021 ◽  
Author(s):  
Pim B van der Meer ◽  
Linda Dirven ◽  
Martin J van den Bent ◽  
Matthias Preusser ◽  
Martin J B Taphoorn ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Brain Tumor ◽  
Adverse Effects ◽  
European Association ◽  
International Survey ◽  
Tumor Patients ◽  
Organization Of Care ◽  
First Choice ◽  
Almost All ◽  
Digital Survey

Abstract Background This study aimed at investigating antiepileptic drug (AED) prescription preferences in patients with brain tumor-related epilepsy (BTRE) among the European neuro-oncology community, the considerations that play a role when initiating AED treatment, the organization of care, and practices with regard to AED withdrawal. Methods A digital survey containing 31 questions about prescription preferences of AEDs was set out among members of the European Association of Neuro-Oncology (EANO). Results A total of 198 respondents treating patients with BTRE participated of whom 179 completed the entire survey. Levetiracetam was the first choice in patients with BTRE for almost all respondents (90% [162/181]). Levetiracetam was considered the most effective AED in reducing seizure frequency (72% [131/181]) and having the least adverse effects (48% [87/181]). Common alternatives for levetiracetam as equivalent first choice included lacosamide (33% [59/181]), lamotrigine (22% [40/181]), and valproic acid (21% [38/181]). Most crucial factors to choose a specific AED were potential adverse effects (82% [148/181]) and interactions with antitumor treatments (76% [137/181]). In the majority of patients neuro-oncologists were involved in the treatment of seizures (73% [132/181])). Other relevant findings were that a minority of respondents ever prescribe AEDs in brain tumor patients without epilepsy solely as prophylaxis (29% [53/181]), but a majority routinely considers complete AED withdrawal in BTRE patients who are seizure free after antitumor treatment (79% [141/179]). Conclusions Our results show that among European professionals treating patients with BTRE levetiracetam is considered the first choice AED, with the presumed highest efficacy and least adverse effects.

P14.49 Prescription preferences of antiepileptic drugs in brain tumor patients: an international survey

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii47-ii47
Author(s):  
P B van der Meer ◽  
L Dirven ◽  
M J van den Bent ◽  
M Preusser ◽  
M J B Taphoorn ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Brain Tumor ◽  
Adverse Effects ◽  
European Association ◽  
International Survey ◽  
Tumor Patients ◽  
Organization Of Care ◽  
First Choice ◽  
Almost All ◽  
Digital Survey

Abstract BACKGROUND This study aimed at investigating antiepileptic drug (AED) prescription preferences in patients with brain tumor-related epilepsy (BTRE) among the European neuro-oncology community, the considerations that play a role when initiating AED treatment, the organization of care, and practices with regard to AED withdrawal. MATERIAL AND METHODS A digital survey containing 31 questions about prescription preferences of AEDs was set out among members of the European Association of Neuro-Oncology (EANO). RESULTS A total of 198 respondents treating patients with BTRE participated of whom 179 completed the entire survey. Levetiracetam was the first choice in patients with BTRE for almost all respondents (90% [162/181]). Levetiracetam was considered the most effective AED in reducing seizure frequency (72% [131/181]) and having the least adverse effects (48% [87/181]). Common alternatives for levetiracetam as equivalent first choice included lacosamide (33% [59/181]), lamotrigine (22% [40/181]), and valproic acid (21% [38/181]). Most crucial factors to choose a specific AED were potential adverse effects (82% [148/181]) and interactions with other antitumor treatments (76% [137/181]). In the majority of patients neuro-oncologists were involved in the treatment of seizures (73% [132/181])). Other relevant findings were that a minority of respondents ever prescribe AEDs in brain tumor patients without epilepsy solely as prophylaxis (29% [53/181]), but a majority routinely consider complete AED withdrawal in seizure free BTRE patients after antitumor treatment (79% [141/179]). CONCLUSION Our results show that among European professionals treating patients with BTRE levetiracetam is considered the first choice AED, with the presumed highest efficacy and least adverse effects.

scholarly journals Anticonvulsant therapy in brain-tumor related epilepsy

2016 ◽  
Vol 24 (1) ◽  
pp. 41-56
Author(s):  
Walter Fröscher ◽  
Timo Kirschstein ◽  
Johannes Rösche
Keyword(s):  
Brain Tumor ◽  
Epileptic Seizures ◽  
Current Evidence ◽  
Chemotherapeutic Drugs ◽  
First Line ◽  
Tumor Patients ◽  
First Line Therapy ◽  
Line Therapy ◽  
First Choice

SummaryBackground. The lifetime risk of patients with brain tumors to have focal epileptic seizures is 10-100%; the risk depends on different histology. Specific guidelines for drug treatment of brain tumor-related seizures have not yet been established.Aim. This review addresses the special aspects of antiepileptic drug (AED) therapy in brain tumor-related epilepsy.Methods. We analyzed the literature up to December 2015.Results. Based on current evidence the management of tumor-related seizures does not differ substantially from that applied to epilepsies from other etiologies. Therefore, the choice of an AED is based, above all, on tolerability and pharmacokinetic interactions with chemotherapeutic drugs. Levetiracetam is recommended by many authors as first-line therapy in brain tumor-related epilepsy. Due to the possibility of interactions, the combination of enzyme-inducing AEDs and chemotherapeutic drugs, is usually not recommended as a first choice. Currently there is no evidence that prophylactic prescription of long-term AEDs in brain tumor-patients who did not present with seizures is justified. Because of the high risk of recurrence, however, AED treatment should be strongly considered after a single brain tumor-related seizure. The decision to withdraw AEDs must carefully consider the risk of seizure recurrence.Conclusion. At present levetiracetam is the preferred drug in brain tumor-related epilepsy, especially when drug interactions need to be avoided. In the future we hope to acquire more targeted drugs against this disorder by uncovering its pathogenesis.

scholarly journals CN-15 * ADVERSE EFFECTS OF BEVACIZUMAB IN BRAIN TUMOR PATIENTS

2014 ◽  
Vol 16 (suppl 5) ◽  
pp. v49-v49
Author(s):  
T. Pawar ◽  
H. Ladha ◽  
J. Mandel ◽  
M. Gilbert ◽  
B. O'Brien ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Adverse Effects ◽  
Tumor Patients

scholarly journals Corticosteroid Therapy for Brain Tumor Patients with Adrenal Insufficiency

2021 ◽  
Vol 9 (F) ◽  
pp. 31-35
Author(s):  
Irwan Barlian Immadoel Haq ◽  
Dirga Rachmad Aprianto ◽  
Rahadian Indarto Susilo ◽  
Joni Wahyuhadi
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Adrenal Insufficiency ◽  
Major Surgery ◽  
Brain Surgery ◽  
Pituitary Macroadenoma ◽  
Tumor Patients ◽  
Almost All ◽  
Hydrocortisone Treatment

The use of corticosteroids in cases of brain tumors has become common to reduce brain edema. However, the use can cause adrenal insufficiency (AI) if used long-term and in large doses and with rapid withdrawal. In cases of pituitary macroadenoma that has undergone surgery, AI may also occur. AI also affects the treatment of brain tumor patients. Hence, AI is an important problem in brain tumors because almost all patients with brain tumors receive corticosteroids at some point in the course of their disease. The management is similar to another AI with focus of hydrocortisone treatment. The adjustment of hydrocortisone dosage in patients whom undergo brain surgery is similar with another major surgery, whether the adjustment for pituitary adenoma patients whom undergo excision is more complicated and careful due to the high risk and incidence of AI in these patients.

scholarly journals Deep Learning in Selected Cancers’ Image Analysis—A Survey

2020 ◽  
Vol 6 (11) ◽  
pp. 121
Author(s):  
Taye Girma Debelee ◽  
Samuel Rahimeto Kebede ◽  
Friedhelm Schwenker ◽  
Zemene Matewos Shewarega
Keyword(s):  
Image Analysis ◽  
Deep Learning ◽  
Brain Tumor ◽  
Medical Image Analysis ◽  
Developed Countries ◽  
Learning Approaches ◽  
Breast Cancers ◽  
Lung Cancers ◽  
First Choice ◽  
Almost All

Deep learning algorithms have become the first choice as an approach to medical image analysis, face recognition, and emotion recognition. In this survey, several deep-learning-based approaches applied to breast cancer, cervical cancer, brain tumor, colon and lung cancers are studied and reviewed. Deep learning has been applied in almost all of the imaging modalities used for cervical and breast cancers and MRIs for the brain tumor. The result of the review process indicated that deep learning methods have achieved state-of-the-art in tumor detection, segmentation, feature extraction and classification. As presented in this paper, the deep learning approaches were used in three different modes that include training from scratch, transfer learning through freezing some layers of the deep learning network and modifying the architecture to reduce the number of parameters existing in the network. Moreover, the application of deep learning to imaging devices for the detection of various cancer cases has been studied by researchers affiliated to academic and medical institutes in economically developed countries; while, the study has not had much attention in Africa despite the dramatic soar of cancer risks in the continent.

scholarly journals Practice variation in perioperative steroid dosing for brain tumor patients: an international survey

2021 ◽  
Author(s):  
Charissa A.C. Jessurun ◽  
Alexander F.C. Hulsbergen ◽  
Nayan Lamba ◽  
Rishi D.S. Nandoe Tewarie ◽  
Timothy R. Smith ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Practice Variation ◽  
International Survey ◽  
Tumor Patients

scholarly journals Genetic variants and cognitive functions in patients with brain tumors

2019 ◽  
Vol 21 (10) ◽  
pp. 1297-1309 ◽  
Author(s):  
Denise D Correa ◽  
Jaya Satagopan ◽  
Axel Martin ◽  
Erica Braun ◽  
Maria Kryza-Lacombe ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cell Cycle ◽  
Dna Repair ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Cell Cycle Regulation ◽  
Cognitive Outcome ◽  
Cholesterol Transport ◽  
Tumor Patients ◽  
Cycle Regulation

AbstractBackgroundPatients with brain tumors treated with radiotherapy (RT) and chemotherapy (CT) often experience cognitive dysfunction. We reported that single nucleotide polymorphisms (SNPs) in the APOE, COMT, and BDNF genes may influence cognition in brain tumor patients. In this study, we assessed whether genes associated with late-onset Alzheimer’s disease (LOAD), inflammation, cholesterol transport, dopamine and myelin regulation, and DNA repair may influence cognitive outcome in this population.MethodsOne hundred and fifty brain tumor patients treated with RT ± CT or CT alone completed a neurocognitive assessment and provided a blood sample for genotyping. We genotyped genes/SNPs in these pathways: (i) LOAD risk/inflammation/cholesterol transport, (ii) dopamine regulation, (iii) myelin regulation, (iv) DNA repair, (v) blood–brain barrier disruption, (vi) cell cycle regulation, and (vii) response to oxidative stress. White matter (WM) abnormalities were rated on brain MRIs.ResultsMultivariable linear regression analysis with Bayesian shrinkage estimation of SNP effects, adjusting for relevant demographic, disease, and treatment variables, indicated strong associations (posterior association summary [PAS] ≥ 0.95) among tests of attention, executive functions, and memory and 33 SNPs in genes involved in: LOAD/inflammation/cholesterol transport (eg, PDE7A, IL-6), dopamine regulation (eg, DRD1, COMT), myelin repair (eg, TCF4), DNA repair (eg, RAD51), cell cycle regulation (eg, SESN1), and response to oxidative stress (eg, GSTP1). The SNPs were not significantly associated with WM abnormalities.ConclusionThis novel study suggests that polymorphisms in genes involved in aging and inflammation, dopamine, myelin and cell cycle regulation, and DNA repair and response to oxidative stress may be associated with cognitive outcome in patients with brain tumors.

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