Use of Dexamethasone in Patients with High-Grade Glioma: A Clinical Practice Guideline

Abstract

phd, || and the Alberta Provincial CNS Tumour Team• Patients who have high-grade tumours, are symptomatic, or have poor life expectancy, can be maintained on a 0.5-1.0 mg dose of dexamethasone daily.• Side effects with dexamethasone are common, and they increase in frequency and severity with increased dose and duration of therapy. Patients should be carefully monitored for endocrine, muscular, skeletal, gastrointestinal, psychiatric, and hematologic complications, and for infections and other general side effects.

Dexamethasone Disrupts Cytoskeleton Organization and Migration of T47D Human Breast Cancer Cells by Modulating the AKT/mTOR/RhoA Pathway

“…It has been reported that GC may affect growth and chemosensitivity of carcinoma cells via diverse mechanisms. Dexamethasone (Dex) is a synthetic GC, which is often used in clinic to treat all kinds of diseases (Kostaras et al, 2014;Sau et al, 2014), such as breast cancers. For example, Nakayama et al found that combination of palonosetron and Dex was an antiemetic treatment of choice for patients with breast cancer treated with anthracycline (Nakayama et al, 2013).…”

Cerebral Oedema, Blood–Brain Barrier Breakdown and the Decrease in Na+,K+-ATPase Activity in the Cerebral Cortex and Hippocampus are Prevented by Dexamethasone in an Animal Model of Maple Syrup Urine Disease

“…Corticosteroids such as dexamethasone have been routinely used in the management of cerebral oedema in patients with brain tumours, meningitis, haemorrhagic stroke and cerebral ischemia [11][12][13][14][15][16][17][18] due to due to their long half-lives and their relatively low mineralocorticoid effects, thereby minimizing sodium and water retention [19,20]. Dexamethasone acts on the glucocorticoid receptor and is highly effective in reducing blood-brain barrier (BBB) permeability [21][22][23][24], inflammatory cascades [25][26][27] and oxidative stress [28][29][30][31] and in modulating Na + ,K + -ATPase activity [32][33][34].…”

Bevacizumab and Temozolomide plus Radiation Regimen for Glioblastoma Multiforme

“…[14][15][16][17][18] Dexamethasone, 4 mg to 24 mg per day, is commonly used for patients with diseaserelated cerebral edema. [19][20][21] While these doses may also provide antiemetic benefit, additional dexamethasone is likely unnecessary.…”