Oral Methylprednisolone Megadose in the Treatment of Recurrent Gliomas and Intracranial Metastases. Preliminary Report
Part of the
Developments in Oncology
book series (DION, volume 66)
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 days q 10–12 wks) was immediately withdrawn if non-tolerated or suspended after 1 cycle if ineffective.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.
KeywordsBrain 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.
Axelrod L.: Glucocorticoid therapy. Medicine 55:39–65, 1976.PubMedCrossRefGoogle Scholar
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
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
Gurcay O., Wilson C.B., Barker M., Eliason J.: Corticosteroid effect on transplantable rat glioma. Arch. Neurol. 24:266–269, 1971.PubMedGoogle Scholar
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
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
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
Long D.M.: Capillary ultrastructure in human metastatic brain tumors. J. Neurosurg. 51:53–58, 1979.CrossRefGoogle Scholar
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
Neulen H.J., Schurmann K.: Steroids and brain edema. Springer-Verlag, Berlin, 1972.Google Scholar
Shapiro W.R., Posner J.B.: Corticosteroid hormones. Arch. Neurol. 30:217–221, 1974.CrossRefGoogle Scholar
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
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
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
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