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ORIGINAL RESEARCH

Efficacy of Personalized Postoperative Epilepsy Management in Patients with Glioblastoma Utilizing IDH1 Gene Assessment

, , , , &
Pages 855-862 | Received 22 Nov 2023, Accepted 20 Mar 2024, Published online: 11 Apr 2024
 

Abstract

Objective

We explored the correlation between the presence of isocitrate dehydrogenase-1 (IDH1) mutations and the incidence of postoperative epilepsy in patients with glioblastoma, as well as assessed the efficacy of preemptive administration of antiepileptic medications in mitigating the occurrence of postoperative epilepsy.

Methods

Fifty-three patients who received a postoperative pathological diagnosis of glioblastoma, were enrolled in this study. Tumor specimens were subjected to IDH1 gene analysis. The patient cohort was stratified based on their IDH1 mutation status and the administration of prophylactic antiepileptic drugs during the postoperative phase. We subsequently conducted a comparative analysis of postoperative epileptic complications within each patient subgroup.

Results

In the cohort of 53 patients under study, the occurrence of epilepsy was observed in 10 out of 21 patients carrying IDH1 mutations, while 5 out of 32 patients with wild-type IDH1 also experienced epilepsy, revealing a statistically significant difference (P < 0.05). Among the 27 patients who received prophylactic antiepileptic drugs, 6 of them developed epilepsy, whereas 9 out of 26 patients who did not receive prophylactic antiepileptic drugs exhibited concurrent epilepsy, with no statistically significant difference (P > 0.05). However, when performing a subgroup analysis, it was found that 3 out of 12 patients with IDH1 mutations who received prophylactic antiepileptic drugs experienced epilepsy, whereas 7 out of 9 patients who did not receive prophylactic antiepileptic drugs developed epilepsy, demonstrating a statistically significant difference (P < 0.05). Furthermore, within the group of 15 patients with wild-type IDH1, 3 patients who received prophylactic antiepileptic drugs developed epilepsy, while 2 cases of epilepsy occurred among the 17 patients who did not receive prophylactic antiepileptic drugs, with no statistically significant difference (P > 0.05).

Conclusion

In individuals with IDH1 mutant glioblastoma who have undergone surgical resection, the implementation of preventive antiepileptic therapy demonstrates a potential to diminish the occurrence of postoperative epilepsy.

Abbreviations

IDH1, isocitrate dehydrogenase 1; GBM, glioblastoma multiforme; KPS, Karnofsky; DNA, deoxyribonucleic acid; SPSS, Statistical Package for the Social Sciences; 2-HG, 2-hydroxyglutaric acid; NADPH, nicotinamide adenine dinucleotide phosphate; NMDA, N-Methyl-D-aspartic acid; AMPA(α-amino-3-hydroxy-5-methylisoxazole-4-propionate; mTOR, mammalian target of rapamycin; AKT, protein kinase B; MAPK, mitogen-activated protein kinase.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

This study was conducted with approval from the Ethics Committee of the Second Affiliated Hospital of Nantong University. This study was conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from all participants.

Acknowledgments

We would like to acknowledge the hard and dedicated work of all the staff who implemented the intervention and evaluation components of the study.

Disclosure

The authors declare that they have no competing interests in this work.

Additional information

Funding

Jiangsu Commisson of Health (No.Z2021017); Jiangsu Commisson of Health (No.QN2023009); Clinical Medical Research Special Project Fund of Nantong University (No.2022LY008).