title: Seizure control following radiotherapy in patients with diffuse gliomas: a retrospective study.
abstract: BACKGROUND
  Little information is available regarding the effect of conventional radiotherapy on glioma-related seizures.
  
  
  METHODS
  In this retrospective study, we analyzed the seizure response and outcome following conventional radiotherapy in a cohort of 43 patients with glioma (33 grade II, 10 grade III) and medically intractable epilepsy.
  
  
  RESULTS
  At 3 months after radiotherapy, seizure reduction was significant (≥ 50% reduction of frequency compared with baseline) in 31/43 patients (72%) of the whole series and in 25/33 patients (76%) with grade II gliomas, whereas at 12 months seizure reduction was significant in 26/34 (76%) and in 19/25 (76%) patients, respectively. Seizure reduction was observed more often among patients displaying an objective tumor response on MRI, but patients with no change on MRI also had a significant seizure reduction. Seizure freedom (Engel class I) was achieved at 12 months in 32% of all patients and in 38% of patients with grade II tumors. Timing of radiotherapy and duration of seizures prior to radiotherapy were significantly associated with seizure reduction.
  
  
  CONCLUSIONS
  This study showed that a high proportion of patients with medically intractable epilepsy from diffuse gliomas derive a significant and durable benefit from radiotherapy in terms of epilepsy control and that this positive effect is not strictly associated with tumor shrinkage as shown on MRI. Radiotherapy at tumor progression seems as effective as early radiotherapy after surgery. Prospective studies must confirm and better characterize the response to radiotherapy.
authors.affiliation: Corresponding Author: Roberta Rudà, MD, Department of Neuro-Oncology, Via Cherasco 15, 10126 Torino, Italy. rudarob@hotmail.com.
authors.forename: Roberta
authors.initials: R
authors.lastname: Rudà
authors.forename: Umberto
authors.initials: U
authors.lastname: Magliola
authors.forename: Luca
authors.initials: L
authors.lastname: Bertero
authors.forename: Elisa
authors.initials: E
authors.lastname: Trevisan
authors.forename: Chiara
authors.initials: C
authors.lastname: Bosa
authors.forename: Cristina
authors.initials: C
authors.lastname: Mantovani
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
authors.forename: Anna
authors.initials: A
authors.lastname: Castiglione
authors.forename: Chiara
authors.initials: C
authors.lastname: Monagheddu
authors.forename: Riccardo
authors.initials: R
authors.lastname: Soffietti
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology / Q000517:prevention & control* / Q000532:radiotherapy; D055815:Young Adult
keywords: diffuse gliomas; radiotherapy; seizure control
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