Twice-daily tapering dexamethasone treatment during cranial radiation for newly diagnosed brain metastases. J Neurooncol 1991 Dec;11(3):235-9
Date
12/01/1991Pubmed ID
1726656DOI
10.1007/BF00165531Scopus ID
2-s2.0-0026332525 (requires institutional sign-in at Scopus site) 42 CitationsAbstract
Twenty evaluable patients with newly diagnosed brain metastases underwent treatment with a novel dose/schedule of dexamethasone aimed at reducing steroid toxicity during palliative radiation therapy. All patients received twice daily dexamethasone starting at 8 mg bid for four days then 4 mg bid for four days then 2 mg bid until the last day of radiation therapy. The radiation prescriptions were not standardized varying from 2000 cGy/5 fractions to 5800 cGy/29 fractions. Fourteen patients received dexamethasone for a minimum of 24 hours before their first radiation treatment and 7 (50%) experienced improvement in neurologic symptoms/signs prior to starting radiation treatments. Fourteen patients completed the planned course of radiation and dexamethasone. Only 1 patient needed to restart dexamethasone within 30 days of finishing radiation because of steroid reversible neurologic deficits. Steroid toxicity was mild including hyperglycemia (1), candida esophagitis (1), steroid pseudorheumatism (2), peripheral edema (1) and steroid withdrawal syndrome (1). Only two toxic events were recorded in patients receiving steroids less than 21 days. Twice daily dexamethasone appears to provide good clinical results with minimal morbidity.
Author List
Weissman DE, Janjan NA, Erickson B, Wilson FJ, Greenberg M, Ritch PS, Anderson T, Hansen RM, Chitambar CR, Lawton CAAuthor
Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Administration, OralAdult
Aged
Brain Edema
Brain Neoplasms
Cranial Irradiation
Dexamethasone
Drug Administration Schedule
Drug Evaluation
Female
Humans
Hyperglycemia
Male
Middle Aged
Palliative Care
Pilot Projects
Rheumatic Diseases
Substance Withdrawal Syndrome