Evidence map›Paper›PMID 19169651›Full record

Trial reportJournal of neuro-oncology2009

Safety and feasibility of switching from phenytoin to levetiracetam monotherapy for glioma-related seizure control following craniotomy: a randomized phase II pilot study.

Daniel A Lim, Phiroz Tarapore, Edward Chang, Marlene Burt, Lenna Chakalian, Nicholas Barbaro, Susan Chang, Kathleen R Lamborn, Michael W McDermott

Registry-linked trialOpen access · hybridAbstract readClinical Trial, Phase IIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of neuro-oncology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06442748 (Short Versus Long-term Levetiracetam in Brain Tumors), which is not on this map. Cited by 55 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 9 pooled it
6.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06442748 phase3recruitingnot on this mapstarted 2024, after this paper: background citation

Short Versus Long-term Levetiracetam in Brain Tumors: A Phase 3 Randomized Controlled Trial (LIBRA)

TypeinterventionalSponsorTata Memorial CentreRan2024 to 2031Enrolled604ConditionsSeizures, Brain Tumors, Antiepileptics, LevetiracetamArmsLevetiracetam
3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 9 syntheses or guidelines pooled it, 144 citations in OpenAlex.

  1. Antiepileptic drugs as prophylaxis for postcraniotomy seizures.The Cochrane database of systematic reviews · 2020
    Pooled it
  2. Management of epilepsy in brain tumors.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2019
    Guideline
  3. Pooled it
  4. Antiepileptic drugs as prophylaxis for postcraniotomy seizures.The Cochrane database of systematic reviews · 2018
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Antiepileptic drugs for treating seizures in adults with brain tumours.The Cochrane database of systematic reviews · 2011
    Pooled it
  10. Seizure prophylaxis in glioma surgery: a synopsis from the SPRING RCT.Health technology assessment (Winchester, England) · 2026
    Trial
  11. Trial
  12. Trial
  13. Article
  14. Article
  15. Article
  16. Patient-Centered Management of Brain Tumor-Related Epilepsy.Current neurology and neuroscience reports · 2024
    Review
  17. Article
  18. Review
  19. Observational
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Daniel A LimDepartment of Neurological Surgery, University of California, San Francisco, 94143, USA. limd@neurosurg.ucsf.edu
Phiroz Tarapore
Edward Chang
Marlene Burt
Lenna Chakalian
Nicholas Barbaro
Susan Chang
Kathleen R Lamborn
Michael W McDermott
Neurological Surgery · USUniversity of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Seizures are common in patients with gliomas, and phenytoin (PHT) is frequently used to control tumor-related seizures. PHT, however, has many undesirable side effects (SEs) and drug interactions with glioma chemotherapy. Levetiracetam (LEV) is a newer antiepileptic drug (AED) with fewer SEs and essentially no drug interactions. We performed a pilot study testing the safety and feasibility of switching patients from PHT to LEV monotherapy for postoperative control of glioma-related seizures. Over a 13-month period, 29 patients were randomized in a 2:1 ratio to initiate LEV therapy within 24 h of surgery or to continue PHT therapy. 6 month follow-up data were available for 15 patients taking LEV and for 8 patients taking PHT. In the LEV group, 13 patients (87%) were seizure-free. In the PHT group, 6 patients (75%) were seizure-free. Reported SEs at 6 months was as follows (%LEV/%PHT group): dizziness (0/14), difficulty with coordination (0/29), depression (7/14) lack of energy or strength (20/43), insomnia (40/43), mood instability (7/0). The pilot data presented here suggest that it is safe to switch patients from PHT to LEV monotherapy following craniotomy for supratentorial glioma. A large-scale, double-blinded, randomized control trial of LEV versus PHT is required to determine seizure control equivalence and better assess differences in SEs.

Indexed as

AdultAgedAged, 80 and overAnticonvulsantsBrain NeoplasmsCraniotomyFemaleGliomaHumansLevetiracetamMaleMiddle AgedPhenytoinPilot ProjectsPiracetamSeizuresAnticonvulsantsLevetiracetamPhenytoinPiracetam

Identifiers

PMID19169651
PMCPMC2687520
OpenAlexW2158031796

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.