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KMID : 0942820090080020155
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Journal of Korean Brain Tumor Society
2009 Volume.8 No. 2 p.155 ~ p.164
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Brain Tumor Associated Epilepsy during Adjuvant Chemotherapy for Brain Tumor
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Park Sung-Hoon
Kim Young-Zoon
Cho Yong-Woon
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Abstract
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Objective: Topiramate is a new anti-epileptic drug with few drug interactions and side effects, which are important obstacles to chemotherapy. The purpose of this prospective observational study was to determine the efficacy of topiramate for the treatment of brain tumor associated epilepsy(BTAE) during adjuvant chemotherapy, and to examine the risk factors for development of BATE.
Methods: From March 2006 to February 2009, 81 patients who underwent adjuvant chemotherapy with concomitant topiramate administration after surgery for a brain tumor were enrolled. The authors determined the number of patients that experienced BTAE and the number of BTAE attacks during chemotherapy according to the following comparative groups：presence versus absence of previous history of BTAE；high risk group versus low risk group；progressive disease versus stable disease.
Results: Overall 73 of the 81 patients(90.1%) remained seizure-free during chemotherapy. Seizure-free rates were 89.3% and 90.6% among patients with or without a previous history of BTAE, respectively(p=0.527), 88.1% and 94.9% among high and low risk patients(p=0.083), and 58.8% and 98.4% among patients with a progressive or a responsive brain tumor(p=0.000). Total 18 seizure attacks occurred. Although the side effects of topiramate were found in 16 patients, they were well tolerable to patients.
Conclusion: Topiramate was found to achieve adequate seizure-control with tolerable side effects during adjuvant chemotherapy in brain tumor patients after surgery. However, responsiveness of brain tumor to chemotherapy importantly modulated the effects of BTAE.
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KEYWORD
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Topiramate, Brain neoplasm, Epilepsy, Adjuvant chemotherapy, Drug interaction
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