Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma

Background: Although patients with glioblastoma require corticosteroids, such as dexamethasone, for symptom control, they could worsen prognosis. However, it is not clear whether personalized corticosteroid doses have this effect. We have examined the effects of different doses of dexamethasone on t...

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Autores: Narváez Martínez, Yislenz, Balaña, Carme, Buxó Pujolràs, Maria, Mateu, Gemma, Gimeno, Alfredo, Blasco Solà, Gerard, Puig Alcántara, Josep, Joly Torta, Maria Carme, Castellví Juan, Marina, Caro Cardera, Jose Luis, Ortega, Alejandro, Cohn, Carlos, Barco, Sonia del
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10256/18028
Acceso en línea:http://hdl.handle.net/10256/18028
Access Level:acceso abierto
Palabra clave:Glioblastoma multiforme
Dexametasona
Dexaméthasone
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repository_id_str
spelling Impact of Dexamethasone on Metabolic Profile and Survival in GlioblastomaNarváez Martínez, YislenzBalaña, CarmeBuxó Pujolràs, MariaMateu, GemmaGimeno, AlfredoBlasco Solà, GerardPuig Alcántara, JosepJoly Torta, Maria CarmeCastellví Juan, MarinaCaro Cardera, Jose LuisOrtega, AlejandroCohn, CarlosBarco, Sonia delGlioblastoma multiformeGlioblastoma multiformeDexametasonaDexaméthasoneBackground: Although patients with glioblastoma require corticosteroids, such as dexamethasone, for symptom control, they could worsen prognosis. However, it is not clear whether personalized corticosteroid doses have this effect. We have examined the effects of different doses of dexamethasone on the metabolic profile and prognosis of patients with glioblastoma. Methods: Patients diagnosed with glioblastoma from 2013 to 2016 were included. We recorded changes in glycemia, glycosylated hemoglobin, insulin, Insulin-like Growth Factor 1 (IGF1), triglycerides, and total cholesterol and correlated these changes with dexamethasone dose, Progression-Free Survival (PFS), and Overall Survival (OS). Results: Among the 32 evaluable patients, the median daily dose of dexamethasone during radiotherapy and concomitant temozolomide was 1.4 mg/day (range=0, 8.3 mg/day). The median cumulative dose of dexamethasone was 250 mg (range=0 to 2,648 mg). Neither dexamethasone during concomitant therapy nor median cumulative dose >250 mg was associated with PFS or OS. Total cholesterol increase at progression relative to baseline levels (+20.5 mg/dL, p=0.04) was associated with cumulative dexamethasone dose >250 mg (p=0.01). Only hyperglycemia was identified as an independent marker of shorter PFS (HR, 3.7; 95% CI=1.3, 10.8; p=0.02) and OS (HR, 8.4; 95% CI=2.6, 27.1; p<0.001). Conclusion: Personalized doses of dexamethasone are not associated with worse outcome. The interrelation between dexamethasone, cholesterol, and outcome merits further investigationClinics in Oncology open2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionpeer-reviewedapplication/pdfhttp://hdl.handle.net/10256/18028Clinics in Oncology, 2019, vol. 4, art. núm. 1654Articles publicats (IdIBGi)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)Inglésinfo:eu-repo/semantics/altIdentifier/issn/2474-1663Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10256/180282026-05-29T05:05:01Z
dc.title.none.fl_str_mv Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma
title Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma
spellingShingle Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma
Narváez Martínez, Yislenz
Glioblastoma multiforme
Glioblastoma multiforme
Dexametasona
Dexaméthasone
title_short Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma
title_full Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma
title_fullStr Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma
title_full_unstemmed Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma
title_sort Impact of Dexamethasone on Metabolic Profile and Survival in Glioblastoma
dc.creator.none.fl_str_mv Narváez Martínez, Yislenz
Balaña, Carme
Buxó Pujolràs, Maria
Mateu, Gemma
Gimeno, Alfredo
Blasco Solà, Gerard
Puig Alcántara, Josep
Joly Torta, Maria Carme
Castellví Juan, Marina
Caro Cardera, Jose Luis
Ortega, Alejandro
Cohn, Carlos
Barco, Sonia del
author Narváez Martínez, Yislenz
author_facet Narváez Martínez, Yislenz
Balaña, Carme
Buxó Pujolràs, Maria
Mateu, Gemma
Gimeno, Alfredo
Blasco Solà, Gerard
Puig Alcántara, Josep
Joly Torta, Maria Carme
Castellví Juan, Marina
Caro Cardera, Jose Luis
Ortega, Alejandro
Cohn, Carlos
Barco, Sonia del
author_role author
author2 Balaña, Carme
Buxó Pujolràs, Maria
Mateu, Gemma
Gimeno, Alfredo
Blasco Solà, Gerard
Puig Alcántara, Josep
Joly Torta, Maria Carme
Castellví Juan, Marina
Caro Cardera, Jose Luis
Ortega, Alejandro
Cohn, Carlos
Barco, Sonia del
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Glioblastoma multiforme
Glioblastoma multiforme
Dexametasona
Dexaméthasone
topic Glioblastoma multiforme
Glioblastoma multiforme
Dexametasona
Dexaméthasone
description Background: Although patients with glioblastoma require corticosteroids, such as dexamethasone, for symptom control, they could worsen prognosis. However, it is not clear whether personalized corticosteroid doses have this effect. We have examined the effects of different doses of dexamethasone on the metabolic profile and prognosis of patients with glioblastoma. Methods: Patients diagnosed with glioblastoma from 2013 to 2016 were included. We recorded changes in glycemia, glycosylated hemoglobin, insulin, Insulin-like Growth Factor 1 (IGF1), triglycerides, and total cholesterol and correlated these changes with dexamethasone dose, Progression-Free Survival (PFS), and Overall Survival (OS). Results: Among the 32 evaluable patients, the median daily dose of dexamethasone during radiotherapy and concomitant temozolomide was 1.4 mg/day (range=0, 8.3 mg/day). The median cumulative dose of dexamethasone was 250 mg (range=0 to 2,648 mg). Neither dexamethasone during concomitant therapy nor median cumulative dose >250 mg was associated with PFS or OS. Total cholesterol increase at progression relative to baseline levels (+20.5 mg/dL, p=0.04) was associated with cumulative dexamethasone dose >250 mg (p=0.01). Only hyperglycemia was identified as an independent marker of shorter PFS (HR, 3.7; 95% CI=1.3, 10.8; p=0.02) and OS (HR, 8.4; 95% CI=2.6, 27.1; p<0.001). Conclusion: Personalized doses of dexamethasone are not associated with worse outcome. The interrelation between dexamethasone, cholesterol, and outcome merits further investigation
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
peer-reviewed
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10256/18028
url http://hdl.handle.net/10256/18028
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/issn/2474-1663
dc.rights.none.fl_str_mv Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Clinics in Oncology open
publisher.none.fl_str_mv Clinics in Oncology open
dc.source.none.fl_str_mv Clinics in Oncology, 2019, vol. 4, art. núm. 1654
Articles publicats (IdIBGi)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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