title: The role of steroids in the management of metastatic carcinoma to the brain. A pilot prospective trial.
abstract: This prospective study attempted to evaluate the indications for glucocorticoids which are commonly given to patients with brain metastases. Twelve patients with histologically confirmed malignancies and radiographically documented brain metastases were enrolled. Patients were scored for general performance status and neurologic function class. All subjects were given high-dose dexamethasone (HDD) for 48 hours and then randomized to receive either intermediate-dose dexamethasone (IDD) or no steroids with cranial radiotherapy. Of these 12 study patients, 3 achieved a complete response, 1 partial response, and 8 nonresponses to HDD. Seven patients had IDD, while five received no IDD. Although a small sample size prevented any statistical analysis, this study does suggest that the place for using glucocorticoids in treating patients with metastatic carcinoma to the brain remains uncertain and should be evaluated in a cooperative prospective trial.
authors.affiliation: Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Florida 33136.
authors.forename: A H
authors.initials: AH
authors.lastname: Wolfson
authors.forename: S M
authors.initials: SM
authors.lastname: Snodgrass
authors.forename: J G
authors.initials: JG
authors.lastname: Schwade
authors.forename: A M
authors.initials: AM
authors.lastname: Markoe
authors.forename: H
authors.initials: H
authors.lastname: Landy
authors.forename: L G
authors.initials: LG
authors.lastname: Feun
authors.forename: K S
authors.initials: KS
authors.lastname: Sridhar
authors.forename: A H
authors.initials: AH
authors.lastname: Brandon
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez
authors.forename: P V
authors.initials: PV
authors.lastname: Houdek
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary*; D017024:Chemotherapy, Adjuvant; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D003907:Dexamethasone