van Zanten, SEMV;
Cruz, O;
Kaspers, GJL;
Hargrave, DR;
van Vuurden, DG;
(2016)
State of affairs in use of steroids in diffuse intrinsic pontine glioma: an international survey and a review of the literature.
Journal of Neuro-Oncology
, 128
(3)
pp. 387-394.
10.1007/s11060-016-2141-x.
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Abstract
Children diagnosed with diffuse intrinsic pontine glioma (DIPG) face a dismal prognosis, with severe neurologic deterioration and inevitable death at a median of 9 months from diagnosis. Steroids are widely prescribed as supportive or palliative treatment although they are known to cause severe side effects that may reduce the quality of life. This study aims to review the current knowledge on, and use of, steroids in DIPG patients. A global questionnaire-study among health care professionals was performed to ascertain information on the current (multi-)institutional and (multi-)national use of steroids, the availability of clinical guidelines, and the need for improvements in prescribing steroids to DIPG patients. In addition, an extensive literature search was performed to review studies investigating steroids in pediatric brain tumor patients. From 150 responding health care professionals, only 7 % had clinical guidelines. The use of steroids was heterogeneous and over 85 % of respondents reported serious side effects. Fourteen articles, with low level of evidence, described the use of steroids in pediatric brain tumor patients. Clinical trials investigating optimal dose or regimen were lacking. This study is a first inventory of the availability of evidence-based information and clinical guidelines, and the current attitude towards the use of steroids in DIPG patients. To date, the risk–benefit ratio of steroids in this disease is yet to be determined. We emphasize the need for clinical trials resulting in guidelines on steroids, and possibly alternative drugs, to optimize the quality of care and quality of life of DIPG patients.
| Type: | Article |
|---|---|
| Title: | State of affairs in use of steroids in diffuse intrinsic pontine glioma: an international survey and a review of the literature |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s11060-016-2141-x |
| Publisher version: | http://dx.doi.org/10.1007/s11060-016-2141-x |
| Language: | English |
| Additional information: | © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Oncology, Clinical Neurology, Neurosciences & Neurology, Diffuse Intrinsic Pontine Glioma (DIPG), Pediatric oncology, Quality of life (QoL), Steroids, Side effects, PERITUMORAL BRAIN EDEMA, STEM TUMORS, PHASE-I, CHILDREN, DEXAMETHASONE, RADIATION, THERAPY, RADIOTHERAPY, MANAGEMENT |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10047212 |
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