The Prognostic Effect of Dexamethasone on Patients With Glioblastoma: A Systematic Review and Meta-Analysis

Abstract

Background: Dexamethasone (DEX) is widely adopted to reduce tumor-associated edema in glioblastoma (GBM) patients despite its side effects. However, the benefits of using DEX in GBM patients remains elusive.Methods: In this study, we performed a comprehensive meta-analysis to address this concern. We searched the relevant studies from PubMed, Web of Science, and EMBASE databases, and then applied random or fixed-effects models to generate estimated summary hazard radios (HRs) and the 95% confidence intervals (CIs). Moreover, subgroup and sensitivity analysis were conducted and publication bias were further evaluated.Results: Ten articles with a total of 2,230 GBM patients were eligible according to the inclusion criteria. In the assessment of overall survival (OS), meta-analysis data revealed that DEX was significantly associated with the poor prognosis of GBM patients (HR=1.44, 95% CI=1.32−1.57). In the progression-free survival (PFS), the pooled results indicated that the use of DEX can increase 48% death risk for GBM patients (HR=1.48, 95% CI=1.11−1.98). Subgroup analyses revealed that DEX was associated with poorer outcome of GBM in subgroup of newly diagnosed patients and GBM patients treated with ≥ 2mg/day. Sensitivity analyses showed that no study changed the pooled results materially for both OS and PFS analyses. The funnel plot had no obvious asymmetry.Conclusion: Our findings partly confirmed that use of DEX was associated with poor treatment outcome in GBM patients. To reach a definitive conclusion, large samples from multi-centers are urgent to address this concern.

Evaluating the safety of perioperative dexamethasone treatment: A retrospective analysis of a single center pediatric low‐grade glioma cohort

“…20 Likewise, a meta-analysis including 2230 adult glioblastoma patients partly confirmed an association of DM application with poor treatment outcome. 21 However, there is no significant data derived from pediatric cohorts available to this day.…”

“…While the effects of DM on cell growth and OS in adult glioma remains controversial, independent studies, as well as a meta-analysis partly confirmed association of a poor treatment outcome with use of DM in adult glioma. 20,21 To our knowledge, no significant clinical data regarding the impact of DM on progression-free survival (PFS) and OS in pLGG has been published to this day.…”

Comparison of Five Prophylactically Intravenous Drugs in Preventing Opioid-Induced Cough: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

“…anohe command of the R package of “gemtc” was utilized by reporting the heterogeneity variance parameter I 2 . I 2 > 50% was regarded as significant heterogeneity, and the random effects models would be utilized; otherwise the fixed effect models would be utilized ( Ma et al, 2021 ; Zhou et al, 2021 ). Sensitivity analysis was also conducted to examine the robustness of our results.…”

Perioperative dexamethasone in high-grade gliomas: the short-term benefits and long-term harms

“…Perioperative dexamethasone use leads to its dependence during adjuvant therapy, which lowers survival. Retrospective analyses of large cohorts and post hoc analysis of two large, multicenter, phase 3 RCTs show that GBM patients treated with dexamethasone during chemoradiation have lower survival (32)(33)(34)(35). Thus, the use of dexamethasone during chemoradiation has declined (36).…”