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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| Published in | Current Neurology and Neuroscience Reports Vol. 17; no. 1; p. 5 |
|---|---|
| Main Authors | , |
| Format | Journal Article Book Review |
| Language | English |
| Published |
New York
Springer US
2017
Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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. |
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| AbstractList | 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.
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 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. 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. 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. BACKGROUNDCorticosteroids 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 REVIEWTo 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 FINDINGSRecent 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. 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. 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. |
| ArticleNumber | 5 |
| Author | Ly, K. Ina Wen, Patrick Y. |
| Author_xml | – sequence: 1 givenname: K. Ina surname: Ly fullname: Ly, K. Ina organization: Center for Neuro-Oncology, Dana-Farber Cancer Institute, Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital – sequence: 2 givenname: Patrick Y. surname: Wen fullname: Wen, Patrick Y. email: patrick_wen@dfci.harvard.edu organization: Center for Neuro-Oncology, Dana-Farber Cancer Institute |
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Corticosteroids are commonly used in the management of primary central nervous system (CNS) tumors and CNS metastases to treat cancer- and... Corticosteroids are commonly used in the management of primary central nervous system (CNS) tumors and CNS metastases to treat cancer- and treatment-related... Background Corticosteroids are commonly used in the management of primary central nervous system (CNS) tumors and CNS metastases to treat cancer- and... BACKGROUNDCorticosteroids are commonly used in the management of primary central nervous system (CNS) tumors and CNS metastases to treat cancer- and... |
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| SubjectTerms | 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 |
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| Title | Clinical Relevance of Steroid Use in Neuro-Oncology |
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