Postoperative Seizures Can Predict Overall Survival of Patients With Newly Diagnosed Supratentorial Isocitrate Dehydrogenase-Wild Glioblastoma Treated With Radiotherapy Plus Concomitant and Adjuvant Temozolomide

术后癫痫发作可预测接受放疗联合同步及辅助替莫唑胺治疗的新诊断幕上异柠檬酸脱氢酶野生型胶质母细胞瘤患者的总生存期。

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Abstract

BACKGROUND: We aimed to evaluate the correlation between postoperative seizures (POS) and overall survival in patients with newly diagnosed supratentorial isocitrate dehydrogenase (IDH)-wild glioblastoma treated with radiotherapy plus concomitant and adjuvant temozolomide. METHODS: This study included 122 patients with newly diagnosed supratentorial IDH-wild glioblastoma who were treated at our hospital between May 2007 and September 2022. Seizures occurring within 7 days after surgery were defined as immediate POS (iPOS). Moreover, seizures from the 8th day after the surgery were defined as delayed POS (dPOS). RESULTS: The median follow-up period and median survival time (MST) from surgery in the entire cohort were 19.3 and 20.4 months, respectively. The rates of iPOS and dPOS in this study were 6.6% (n=8) and 38.5% (n=47), respectively. The MST of patients with iPOS and without iPOS was 27.6 and 20 months, respectively. There was no significant difference between with iPOS and without iPOS. The median time to onset of dPOS was 126 days after surgery. The MST of patients with dPOS and without dPOS was 25.9 and 18.4 months, respectively. Patients with dPOS showed significantly longer survival than those without dPOS (p=0.024). Occurrence of seizures at the initial manifestation of disease was found to be significantly more likely to cause dPOS (p=0.044). CONCLUSION: Among patients with newly diagnosed supratentorial IDH-wild glioblastoma, the prognosis of patients with seizures in the postoperative course was better than that of patients without dPOS.

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