Dirk Rades1, Jaspar Witteler2, Troels W Kjaer3, Soeren Tvilsted4, Steven E Schild5. 1. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany dirk.rades@uksh.de. 2. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany. 3. Neurological Department, Zealand University Hospital, Roskilde, Denmark. 4. Research Projects and Clinical Optimization, Zealand University Hospital, Koege, Denmark. 5. Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
Abstract
BACKGROUND/AIM: Seizures can be the initial symptom of brain metastases. This study investigated pre-treatment seizures in patients with a single lesion. PATIENTS AND METHODS: Pre-operative seizures were analyzed in 104 patients with a single brain metastasis receiving resection plus whole-brain irradiation and a boost. Prevalence of seizures, risk factors and associations with survival (OS) were evaluated. RESULTS: Thirty patients (34.6%) had seizures prior to neurosurgery. Significant associations between seizures and investigated characteristics were not found. However, age ≤61 years showed a trend (p=0.117) for increased incidence of seizures. Time from diagnosis of malignancy until neurosurgery >12 months was significantly associated with improved OS on univariate analysis (p=0.003). Trends for a positive association with OS were found for no seizures (p=0.054), female gender (p=0.066) and breast cancer (p=0.098). On multivariate analysis, time until neurosurgery >12 months was independently associated (p=0.019) with better OS, and seizures showed a trend (p=0.119) for improved OS. CONCLUSIONS: Considering the high prevalence of seizures in this cohort, regular screening and monitoring of these patients appears reasonable. This applies particularly to patients aged ≤61 years. Copyright
BACKGROUND/AIM: Seizures can be the initial symptom of brain metastases. This study investigated pre-treatment seizures in patients with a single lesion. PATIENTS AND METHODS: Pre-operative seizures were analyzed in 104 patients with a single brain metastasis receiving resection plus whole-brain irradiation and a boost. Prevalence of seizures, risk factors and associations with survival (OS) were evaluated. RESULTS: Thirty patients (34.6%) had seizures prior to neurosurgery. Significant associations between seizures and investigated characteristics were not found. However, age ≤61 years showed a trend (p=0.117) for increased incidence of seizures. Time from diagnosis of malignancy until neurosurgery >12 months was significantly associated with improved OS on univariate analysis (p=0.003). Trends for a positive association with OS were found for no seizures (p=0.054), female gender (p=0.066) and breast cancer (p=0.098). On multivariate analysis, time until neurosurgery >12 months was independently associated (p=0.019) with better OS, and seizures showed a trend (p=0.119) for improved OS. CONCLUSIONS: Considering the high prevalence of seizures in this cohort, regular screening and monitoring of these patients appears reasonable. This applies particularly to patients aged ≤61 years. Copyright
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