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Neuro-Oncology pp 243-248 | Cite as

Oral Methylprednisolone Megadose in the Treatment of Recurrent Gliomas and Intracranial Metastases. Preliminary Report

  • M. A. Gerosa
  • C. Licata
  • A. Nicolato
  • L. Cristofori
  • M. Vitale
  • J. C. Grosslercher
  • C. Vivenza
  • A. Bricolo
Part of the Developments in Oncology book series (DION, volume 66)

Abstract

Between 1987–1990 a series of 43 consecutive patients with inoperable brain tumors, either recurrent malignant gliomas (26 cases) or intracranial metastases (17 cases) have been treated with oral methylprednisolone megadose in our department, for a total amount of 35 evaluable (1 completed cycle) cases: 22 recurrent gliomas and 13 metastases. Eligibility criteria included a Karnofsky score over 40, age over 18, no further indications for surgery or radiation therapy. Pre-treatment grading was based upon a neurological, radiological (CT scan) and performance score. Oral methylprednisolone megadose schedule ( 1 cycle: 300 mg/sq.m. p.o./alt. days q 10–12 wks) was immediately withdrawn if non-tolerated or suspended after 1 cycle if ineffective. Each single cycle was routinely followed by a day-hospital re-grading with laboratory controls. Even though a long-term follow-up is still under evaluation, preliminary results indicate an improved quality of life, with no steroid-dependency and a dramatic decrease in gastro-enteric side-effects.

Actuarial survival rates show a slight increase, statistically non-significant.

Keywords

Brain Metastasis Malignant Glioma Brain Edema Intracranial Hypertension Metastatic Brain Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Axelrod L.: Glucocorticoid therapy. Medicine 55:39–65, 1976.PubMedCrossRefGoogle Scholar
  2. 2.
    Ellemann K., Bollinger B., Soelberg-SOERENSEN P., Zeeberg I.: The antineoplastic effect of methylprednisolone pulse therapy in two patients with glucocorticoid receptor-positive glioblastoma multiforme. Acta Neurol. Scand. 77:74–77, 1988.PubMedGoogle Scholar
  3. 6.
    Freshney R.J., Sherry A., Hessauzadag M., et al.: Control of cell proliferation in human glioma by glucocorticoids. Br. J. Cancer 41:857–866, 1980.PubMedGoogle Scholar
  4. 8.
    Gurcay O., Wilson C.B., Barker M., Eliason J.: Corticosteroid effect on transplantable rat glioma. Arch. Neurol. 24:266–269, 1971.PubMedGoogle Scholar
  5. 10.
    Hasegawa H., Ushio Y., Hayakawa T., et al.: Changes of the blood-brain-barrier in experimental metastatic brain tumors. J. Neurosurg. 59:304–310, 1983.PubMedGoogle Scholar
  6. 13.
    Lee J.K., Choi B., Sobel R.A., et al.: Inhibition of growth and angiogenesis of human neurofibrosarcoma by heparin and hydrocortisone. J. Neurosurg. 73:429–436, 1990.PubMedCrossRefGoogle Scholar
  7. 14.
    Leiguarda R., Sierra J., Pardal G., et al.: Effects of large doses of methylprednisolone on supratentorial intracranial tumors. A clinical and CAT scan evaluation. Eur. Neurol. 24:23–32, 1985.PubMedCrossRefGoogle Scholar
  8. 15.
    Long D.M.: Capillary ultrastructure in human metastatic brain tumors. J. Neurosurg. 51:53–58, 1979.CrossRefGoogle Scholar
  9. 17.
    Mealey J., Chen T.T., Schanz G.P.: Effects of dexamethasone and methylprednisolone on cell cultures of human glioblastomas. J. Neurosurg. 34:324–334, 1971.Google Scholar
  10. 19.
    Neulen H.J., Schurmann K.: Steroids and brain edema. Springer-Verlag, Berlin, 1972.Google Scholar
  11. 20.
    Shapiro W.R., Posner J.B.: Corticosteroid hormones. Arch. Neurol. 30:217–221, 1974.CrossRefGoogle Scholar
  12. 22.
    Yamashita T., Kutawara T.: Estimation of rate of growth of malignant brain tumors by computed tomography scanning. Surg. Neurol. 20:464–470, 1983.CrossRefGoogle Scholar
  13. 24.
    Weinstein J.D., Toy F.J., Jaffe M.E.: The effect of dexamethasone on brain edema in patients with metastatic brain tumors. Neurology 23:121–129, 1973.PubMedCrossRefGoogle Scholar
  14. 25.
    Wright R.L., Shaumba B., Keller J.: The effect of glucocortico-steroids on growth and metabolism of experimental glial tumors. J. Neurosurg. 30:140–145, 1969.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1991

Authors and Affiliations

  • M. A. Gerosa
    • 1
  • C. Licata
    • 1
  • A. Nicolato
    • 1
  • L. Cristofori
    • 1
  • M. Vitale
    • 1
  • J. C. Grosslercher
    • 1
  • C. Vivenza
    • 1
  • A. Bricolo
    • 1
  1. 1.Department of NeurosurgeryUniversity of VeronaItaly

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