TY - JOUR
T1 - Corticosteroids use and neurocognitive functioning in patients with recurrent glioblastoma
T2 - Evidence from European Organization for Research and Treatment of Cancer (EORTC) trial 26101
AU - Caramanna, Ivan
AU - de Kort, Julie M
AU - Brandes, Alba A
AU - Taal, Walter
AU - Platten, Michael
AU - Idbaih, Ahmed
AU - Frenel, Jean Sebastien
AU - Wick, Wolfgang
AU - Preetha, Chandrakanth Jayachandran
AU - Bendszus, Martin
AU - Vollmuth, Philipp
AU - Reijneveld, Jaap C
AU - Klein, Martin
N1 - Publisher Copyright: © 2022 The Author(s).
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Background: In patients with recurrent glioblastoma, corticosteroids are frequently used to mitigate intracranial pressure and to improve patient neurological functioning. To date, in these patients, no systematic studies have been performed to assess neurocognitive functioning (NCF) in relation to corticosteroid treatment. Methods: Using baseline data (ie, prior to randomization) of European Organization for Research and Treatment of Cancer (EORTC) trial 26101, we performed regression analysis to assess the predictive value of corticosteroid intake on performance of the EORTC brain tumor clinical trial NCF test battery. The battery is comprised of the Hopkins Verbal Learning Test-Revised (HVLT-R), Controlled Oral Word Association Test (COWA), and Trail Making Test (A and B). Results: Out of 321 patients, 148 (46.1%) were not using corticosteroids, and 173 were using dexamethasone (34.3%), methylprednisolone (9.7%), or other corticosteroids (9.9%). Patients on corticosteroids had worse performance on all neurocognitive tests. Regression analyses demonstrated a negative association between corticosteroids use and the HVLT-R free recall score (R2 change = 0.034, F change (1, 272) = 13.392, P <. 001) and HVLT-R Delayed Recall score (R2 change = 0.028, F change (1, 270) = 10.623, P =. 002). No statistically significant association was found for HVLT-R Delayed recognition, COWA, TMT part A and TMT part B (P >. 05). Conclusions: Glioblastoma patients prescribed with corticosteroids show poorer memory functions, expressive language, visual-motor scanning speed, and executive functioning than patients not using corticosteroids. Furthermore, we found a negative association between corticosteroid intake and memory functions. The possibility of deleterious effects of corticosteroids on NCF should be considered during clinical decision making.
AB - Background: In patients with recurrent glioblastoma, corticosteroids are frequently used to mitigate intracranial pressure and to improve patient neurological functioning. To date, in these patients, no systematic studies have been performed to assess neurocognitive functioning (NCF) in relation to corticosteroid treatment. Methods: Using baseline data (ie, prior to randomization) of European Organization for Research and Treatment of Cancer (EORTC) trial 26101, we performed regression analysis to assess the predictive value of corticosteroid intake on performance of the EORTC brain tumor clinical trial NCF test battery. The battery is comprised of the Hopkins Verbal Learning Test-Revised (HVLT-R), Controlled Oral Word Association Test (COWA), and Trail Making Test (A and B). Results: Out of 321 patients, 148 (46.1%) were not using corticosteroids, and 173 were using dexamethasone (34.3%), methylprednisolone (9.7%), or other corticosteroids (9.9%). Patients on corticosteroids had worse performance on all neurocognitive tests. Regression analyses demonstrated a negative association between corticosteroids use and the HVLT-R free recall score (R2 change = 0.034, F change (1, 272) = 13.392, P <. 001) and HVLT-R Delayed Recall score (R2 change = 0.028, F change (1, 270) = 10.623, P =. 002). No statistically significant association was found for HVLT-R Delayed recognition, COWA, TMT part A and TMT part B (P >. 05). Conclusions: Glioblastoma patients prescribed with corticosteroids show poorer memory functions, expressive language, visual-motor scanning speed, and executive functioning than patients not using corticosteroids. Furthermore, we found a negative association between corticosteroid intake and memory functions. The possibility of deleterious effects of corticosteroids on NCF should be considered during clinical decision making.
KW - Corticosteroids
KW - Glioblastoma
KW - Memory
KW - Neurocognitive functioning
KW - Neuroimaging
UR - http://www.scopus.com/inward/record.url?scp=85135757142&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/nop/npac022
DO - https://doi.org/10.1093/nop/npac022
M3 - Article
C2 - 35855458
SN - 2054-2577
VL - 9
SP - 310
EP - 316
JO - Neuro-Oncology Practice
JF - Neuro-Oncology Practice
IS - 4
ER -