Publicação
Post-Therapy Epilepsy Prevalence in Patients with High-Grade Gliomas: a systematic review and meta-analysis
| Resumo: | High-grade gliomas are the most common type of malignant glioma. Seizures are frequently the first clinical manifestation of high-grade gliomas. Seizure-control is one of the main goals of treatment due to the impact in quality of life of these patients. Besides it impacts in morbidity and mortality rates there is a lack of evidence in the prevalence of post- therapy epilepsy. Our main goal was to evaluate the prevalence of epilepsy after the end of high-grade gliomas treatment. Our search was conducted across PubMed®️, EMBASE®️, Web of Science™️, Cochrane Library, Sicelo and Scopus, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included all studies conducted on adults with newly diagnosed high-grade gliomas, who were treated with at least surgery or radiotherapy, and assessed for long-term side-effects (accounting for seizures) and published in Portuguese or English. Thirty-six studies were included in the meta-analysis, encompassing a total of 4036 patients with high-grade gliomas. Patient’s mean age ranged from 44 to 73 years, with a diagnosis of glioblastoma in 77,8% of all patients. Pretreatment seizures were observed in 21,2% of all cases. Surgery was the main treatment for all studies, with 1842 patients undergoing adjuvant therapy. Our meta-analysis identified a pooled prevalence of post-therapy seizures of 25.5%, with a 95% confidence interval of [19.9%;31.1%] (Z=8.90, p<.001). A significant heterogeneity between studies was observed (I2=96%, Q(35)=784, p<.001) with no significant asymmetry in funnel plot analysis (Z=1.27, p=.20). High-grade gliomas are a recognized trigger for seizures. A high heterogeneity in all the evaluated variables was observed. To minimize the diversity of results, a larger prospective studies using appropriate epilepsy diagnostic techniques would be beneficial to have a more exact number of the high-grade glial patients that develop post-therapy epilepsy. |
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| Autores principais: | Borges, Daniel Filipe |
| Outros Autores: | Soares, Joana I.; Casalta-Lopes, João; Ferreira, Marta Pereira; Carvalho, Ruben |
| Assunto: | High-grade gliomas Malignant glioma Epilepsy |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | documento de conferência |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Instituto Politécnico do Porto |
| Idioma: | inglês |
| Origem: | Repositório Científico do Instituto Politécnico do Porto |
| Resumo: | High-grade gliomas are the most common type of malignant glioma. Seizures are frequently the first clinical manifestation of high-grade gliomas. Seizure-control is one of the main goals of treatment due to the impact in quality of life of these patients. Besides it impacts in morbidity and mortality rates there is a lack of evidence in the prevalence of post- therapy epilepsy. Our main goal was to evaluate the prevalence of epilepsy after the end of high-grade gliomas treatment. Our search was conducted across PubMed®️, EMBASE®️, Web of Science™️, Cochrane Library, Sicelo and Scopus, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included all studies conducted on adults with newly diagnosed high-grade gliomas, who were treated with at least surgery or radiotherapy, and assessed for long-term side-effects (accounting for seizures) and published in Portuguese or English. Thirty-six studies were included in the meta-analysis, encompassing a total of 4036 patients with high-grade gliomas. Patient’s mean age ranged from 44 to 73 years, with a diagnosis of glioblastoma in 77,8% of all patients. Pretreatment seizures were observed in 21,2% of all cases. Surgery was the main treatment for all studies, with 1842 patients undergoing adjuvant therapy. Our meta-analysis identified a pooled prevalence of post-therapy seizures of 25.5%, with a 95% confidence interval of [19.9%;31.1%] (Z=8.90, p<.001). A significant heterogeneity between studies was observed (I2=96%, Q(35)=784, p<.001) with no significant asymmetry in funnel plot analysis (Z=1.27, p=.20). High-grade gliomas are a recognized trigger for seizures. A high heterogeneity in all the evaluated variables was observed. To minimize the diversity of results, a larger prospective studies using appropriate epilepsy diagnostic techniques would be beneficial to have a more exact number of the high-grade glial patients that develop post-therapy epilepsy. |
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