Abstract Background Recent evidence has demonstrated a tight relationship between neuronal activity and GBM growth, involving novel mechanisms such as neuron-glioma synapses and tumour microtube networks. Seizure activity and antiepileptic drug (AED) usage are highly prevalent amongst GBM patients. In this present study, we investigate the impact of AEDs and their mechanism of action on overall survival (OS) in a cohort of patients treated for glioblastoma. Methods We performed a retrospective, single-centre study of a cohort of histopathologically-proven GBM patients at a tertiary centre. Multivariate analyses were performed at 4 different timepoints by i) patients who did and did not use AEDs; ii) use of individual AEDs and iii) use of AEDs with the same mechanism of action. Results A total of 236 patients were included in the analysis, 178 of which were on anti-epileptics (75.4%). There was no significant impact of AEDs overall in OS—median survival was 16.2 months for patients taking AEDs and 13.8 months for patients not. Being on a voltage-gated sodium channel (VGNC) blocker seemed to confer a significant survival advantage at 24 months when compared to patients not on AEDs (HR = 0.67, p = 0.045). This significance was however lost when corrected for covariates (multivariable HR = 1.01, CI: 0.67—1.54, p = 0.953). While patients on adjuvant treatment had a higher OS, this was only the case in patients taking AEDs. Conclusion There was no significant effect of AEDs on OS, VGNC blockers trended towards significance at 24 months. However, a link may exist between AEDs and the impact of adjuvant treatments.
Genel et al. (Wed,) studied this question.
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