Reassessing Corticosteroid Use in Neuro-Oncology Practices

Corticosteroids, particularly dexamethasone, have been staples in treating malignant brain tumors for decades. Initially prescribed to control symptoms like mass effect and elevated intracranial pressure due to edema, the actual effectiveness and response variability of these drugs remain ambiguous. Recent studies have raised doubts about the extent of edema reduction seen on imaging from steroids. Additionally, newer research suggests that lower doses might be as effective as traditional amounts in symptom management. This backdrop of uncertain efficacy, coupled with concerns about steroids shortening survival in glioblastoma patients and potentially interfering with immunotherapy, demands a critical reevaluation of their use.

This Research Topic aims to clarify the value of corticosteroids in treating patients with malignant brain tumors. With recent data highlighting variable response rates and questioning the necessity of high-dose treatments, this research seeks to better define suitable candidates for steroid therapy and optimal dosing strategies. Given the shifting paradigms about steroid use in neuro-oncology, this topic is timely and essential.

To gather further insights in this area, we welcome contributions that span a range of methodologies and focuses, including:
o Basic, clinical, and translational research methodologies.
o Retrospective studies, case-control studies, and prospective trials.
o Investigations into the mechanisms of action of steroids, both clinical and translational.
o Clinical trials evaluating non-standard dosing of steroids.
o Comparative effectiveness research across different patient demographics, including pediatric and adult populations.
o Papers focusing on primary brain tumors and brain metastasis.

Note, however, that studies relying solely on in silico models without clinical or functional validation, and manuscripts that lack robust institutional cohort data will not be included in this collection.