SHOULD CALCIUM SUPPLEMENTS BE PRESCRIBED PROPHYLACTICALLY FOR PATIENTS DIAGNOSED WITH A HIGH-GRADE GLIOMA (HGG) ON PROLONGED STEROID USE?

Abstract

Abstract AIMS The case study review will evaluate whether patients on long term steroid would benefit from calcium supplements and if a protocol for a bone density scan should be in place in relation to how long patients have been on steroids for. Duration of steroid use increases patients’ risk to steroid related toxicity when taken more than 3 weeks. These can include endocrine, skeletal and psychiatric side effects amongst many others. It is therefore important to assess how we can improve patients’ quality of life (QOL) with limited prognosis. METHOD In a single centre, patients diagnosed with a HGG will be reviewed if they were diagnosed with osteoporosis or spinal fractures between 2020- 2022, subsequent from prolonged steroid use. RESULTS All 7 patients identified had presented with severe lower back pain. 4 patients initially had bone density scans which prompted an MRI due to low minerals for patient age and osteoporosis, whilst the remaining 3 patients only had an MRI scan. All 7 patients had spinal fractures. The average dexamethasone use was 9 months unable to wean to stop. CONCLUSIONS Patients diagnosed with a HGG tumour sadly continue to have poor prognosis. For patients who have had limited debulking or biopsy only, this leaves them prone to require ongoing steroid use to help with side effects to improve QOL. Though the figures are small, we can see patients who struggled to wean to stop dexamethasone since their intracranial surgery have had their QOL impacted due to steroid toxicities with no previous related comorbidities.