Impact of postoperative dexamethasone on survival, steroid dependency, and infections in newly diagnosed glioblastoma patients

• DOI: 10.1093/nop/npab039
• Publication Date: 2021-06-23T13:32:26Z
• Authors: Akshitkumar M Mistry; Sumeeth V Jonathan; Meredith A Monsour; Bret C Mobley; Stephen W Clark; Paul L Moots
• Keywords: Temozolomide

Abstract Background We examined the effect of dexamethasone prescribed in initial 3 postoperative weeks on survival, steroid dependency, and infection glioblastoma patients. Methods In this single-center retrospective cohort analysis, we electronically retrieved inpatient administration outpatient prescriptions laboratory values from medical record 360 correlated total day (POD) 0 to 21 with prescription POD30 POD90, diagnosis an by POD90. These analyses were adjusted for age, Karnofsky performance status score, tumor volume, extent resection, IDH1/2 mutation, MGMT promoter methylation, temozolomide radiotherapy initiation, maximum blood glucose level. Results Patients a median 159 mg [109-190] cumulatively POD21. Every 16-mg increment (4 every 6 hours/day) associated 4% increase mortality (95% confidence interval [CI] 1%-7%, P < .01), 12% odds being POD90 CI 6%-19%, 10% diagnosed CI, 4%-17%, .01). Of 175 patients who had their absolute lymphocyte count measured preoperative week, 80 (45.7%) value indicative lymphopenia. POD1-POD28 period, proportion was 82/167 (49.1%). Conclusions Lower higher rate weeks. Nearly half are lymphopenic preoperatively up 1 month postoperatively.