Retrospective Study of The Corticosteroids Administration in Glioblastoma Patients as A Prognostic Factor in The Disease

Abstract

Background: Glioblastoma multiforme (GBM) is the most common and most malignant of the glial tumors. Optimum management consists of maximal safe surgical resection, followed by concurrent chemo-radiotherapy treatment then adjuvant chemotherapy with temozolomide. A considerable part from the care of patients with GBM involves general medical management, containing corticosteroids. Despite steroids common use, there is experimental and clinical evidence that corticosteroids have direct effects on tumor cell proliferation and apoptosis. Aim of the Work: was to discuss the clinical relation between corticosteroids usage in Glioblastoma Multiforme (GBM) patients and quality of life as well as the disease progression free survival according to the recorded data from the joined hospitals. Patients and Methods: Retrospective analysis of 66 adult patients diagnosed with GBM by surgery or imaging criteria. In order to assess the relation between corticosteroid dependence and the survival, patients were recruited into two groups (arms) according to dependency. Arm (A) was steroid dependent (34 patients) and arm (B) was steroid non-dependent (32 patients). Results: Corticosteroids dependency was statistically significant correlated to both Overall Survival (OS)(median 2.5 in arm (A) vs. 13.1 months in the arm (B), p < 0.001), and Progression-free survival ratio (PFS)(median 2.3 in arm (A) vs. 9.4 months in arm (B), p = 0.035). Also, steroid dependency was independent prognostic factor by doing the COX regression analysis. Conclusion: Dependence on corticosteroids during course of treatment is identified as a poor prognostic factor.