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[Fractionated stereotactically guided radiotherapy for pharmacoresistant epilepsy]
Gerhard G Grabenbauer1, Christian Reinhold, Frank Kerling
1Klinik und Poliklinik für Strahlentherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany. gerd.grabenbauer@strahlen.med.uni-erlangen.de
Aim:
This prospective study evaluated the efficiency of fractionated stereotactically guided radiotherapy as a treatment of pharmacoresistant temporal lobe epilepsy.
Patients And Methods:
Inclusion criteria were patients aged between 17 and 65 years with one-sided temporally located focus, without sufficient epilepsy control by antiepileptic drugs or neurosurgery. Between 1997 and 1999, two groups of six patients each were treated with 21 Gy (7 times 3 Gy) and 30 Gy (15 times 2 Gy). Study end points were seizure frequency, intensity, seizure length and neuropsychological parameters.
Results:
All patients experienced a marked reduction in seizure frequency. The mean reduction of seizures was 37% (range 9-77%, i. e. seizures reduced from a monthly mean number of 11.75 to 7.52) at 18 months following radiation treatment and 46% (23-94%, i. e. 0.2-23 seizures per month) during the whole follow-up time. Seizure length was reduced in five out of eleven patients and intensity of seizures in seven out of eleven patients.
Conclusion:
Radiotherapy was identified as safe and effective for pharmacoresistant epilepsy since a very good reduction of seizure frequency was observed. It is no substitute for regular use of antiepileptic drugs, but means an appropriate alternative for patients with contraindication against neurosurgery or insufficient seizure reduction after neurosurgery.