Association between survival and levetiracetam use in glioblastoma patients treated with temozolomide chemoradiotherapy

This study was conducted to assess whether levetiracetam (LEV) affects the survival of patients with glioblastoma (GBM) treated with concurrent temozolomide (TMZ) chemotherapy. To this end, from 2004 to 2016, 322 patients with surgically resected and pathologically confirmed isocitrate dehydrogenase (IDH)-wildtype GBM who received TMZ-based chemoradiotherapy were analysed. The patients were divided into two groups based on whether LEV was used as an anticonvulsant both at the time of surgery and the first visit thereafter. The median overall survival (OS) and progression-free survival (PFS) were compared between the groups. The OS was 21.1 and 17.5 months in the LEV (+) and LEV (-) groups, respectively (P=0.003); the corresponding PFS was 12.3 and 11.2 months (P=0.017). The other prognostic factors included age, extent of resection, O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status, and Karnofsky Performance Status (KPS) score. The multivariate analysis showed age (hazard ratio [HR], 1.02; P<0.001), postoperative KPS score (HR 0.99; P=0.002), complete tumour resection (HR 0.52; P<0.001), MGMT promoter methylation (HR 0.75; P<0.001), and LEV use (HR 0.72; P=0.011) were significantly associated with OS. In conclusion, LEV use was associated with prolonged survival in patients with GBM treated with concurrent TMZ chemoradiotherapy.