Clinical Relevance of Steroid Use in Neuro-Oncology

Background Corticosteroids are commonly used in the management of primary central nervous system (CNS) tumors and CNS metastases to treat cancer- and treatment-related cerebral edema and improve neurologic function. However, they are also associated with significant morbidity and mortality, given th...

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Bibliographic Details
Published inCurrent Neurology and Neuroscience Reports Vol. 17; no. 1; p. 5
Main Authors Ly, K. Ina, Wen, Patrick Y.
Format Journal Article Book Review
LanguageEnglish
Published New York Springer US 2017
Springer Nature B.V
Subjects
Adrenal Cortex Hormones - adverse effects
Adrenal Cortex Hormones - therapeutic use
Animals
Brain Edema - etiology
Central Nervous System Neoplasms - complications
Central Nervous System Neoplasms - diagnostic imaging
Central Nervous System Neoplasms - drug therapy
Glioma - drug therapy
Humans
Magnetic Resonance Imaging
Medicine
Medicine & Public Health
Neoplasm Grading
Neuro-Oncology (LE Abrey
Neurology
Neurosciences
Section Editor
Topical Collection on Neuro-Oncology
Brain tumor
Brain metastases
Corticosteroids
Cerebral edema
Response assessment
Steroids
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Summary:Background Corticosteroids are commonly used in the management of primary central nervous system (CNS) tumors and CNS metastases to treat cancer- and treatment-related cerebral edema and improve neurologic function. However, they are also associated with significant morbidity and mortality, given their wide range of adverse effects. Purpose of Review To review the mechanism of action, pharmacology, and toxicity profile of corticosteroids and to critically appraise the evidence that supports their use in neuro-oncologic practice based on the latest scientific and clinical data. Recent Findings Recent data suggest that corticosteroids may negatively impact survival in glioma patients. In addition, corticosteroids should be incorporated as a standard criterion to assess a patient’s clinical and radiographic response to treatment. Summary Corticosteroids should be used judiciously in neuro-oncologic patients, given the potential deleterious effects on clinical outcome and patient survival. Anti-angiogenic agents, which lack these adverse effects, may be a reasonable alternative to corticosteroids.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ObjectType-Review-1
ISSN:1528-4042
1534-6293
DOI:10.1007/s11910-017-0713-6