Corticosteroids use and neurocognitive functioning in patients with recurrent glioblastoma: Evidence from European Organization for Research and Treatment of Cancer (EORTC) trial 26101

Ivan Caramanna, Julie M. De Kort, Alba A. Brandes, Walter Taal, Michael Platten, Ahmed Idbaih, Jean Sebastien Frenel, Wolfgang Wick, Chandrakanth Jayachandran Preetha, Martin Bendszus, Philipp Vollmuth, Jaap C. Reijneveld, Martin Klein*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
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Abstract

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.

Original languageEnglish
Pages (from-to)310-316
Number of pages7
JournalNeuro-Oncology Practice
Volume9
Issue number4
DOIs
Publication statusPublished - Aug 2022

Bibliographical note

Funding:
This study was funded by the European Organisation for
Research and Treatment of Cancer, Quality of Life Group (grant
no. 007/2016).

Publisher Copyright: © 2022 The Author(s).

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