Background/aim: Prolonged use of glucocorticoids (GC) in glioma treatment can lead to adrenal insufficiency (AI) and subsequent steroid dependence due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis. This is challenging to diagnose due to its nonspecific clinical symptoms erroneously ascribed to treatment. This study aimed to evaluate the risk factors predisposing patients with gliomas to develop AI.
Patients And Methods: Charts in the neuro-oncology clinic from July 2018 to March 2019 were reviewed. Inclusion criteria included >18 y/o with WHO Grade II-IV gliomas, and secondary AI. Demographic profile, tumor characteristics, and treatment profile were compared.
Results: The majority of patients were started on high dose dexamethasone at >8 mg daily, and were on dexamethasone for 4-8 months. The minimum dose needed to prevent symptoms was 0.5 mg to 2 mg daily. The majority received standard radiation doses ranging from 54-60 Gy. Most patients had radiation exposure to the HPA axis within the prescription isodose levels.
Conclusion: Prolonged steroid dependency can result from chronic GC use in patients with glioma. Dose and duration of GC are risk factors for its development. Radiation exposure to the HPA axis may also be a contributing factor.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.21873/anticanres.14163 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The NE/AAT/CBG axis regulates adipose tissue glucocorticoid exposure.
Nat Commun
January 2025
University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
Corticosteroid binding globulin (CBG; SERPINA6) binds >85% of circulating glucocorticoids but its influence on their metabolic actions is unproven. Targeted proteolytic cleavage of CBG by neutrophil elastase (NE; ELANE) significantly reduces CBG binding affinity, potentially increasing 'free' glucocorticoid levels at sites of inflammation. NE is inhibited by alpha-1-antitrypsin (AAT; SERPINA1).
View Article and Find Full Text PDFPossible effects of radiofrequency electromagnetic radiation on contextual fear conditioning, hippocampal perivascular space, apoptosis and adrenal gland microarchitecture in rats.
Behav Brain Res
January 2025
Division of Biotechnology, School of Life Sciences, Manipal Academy of Higher Education, Manipal- 576104, India.
Whilst the world sees the tremendous growth of mobile phone technology, radiofrequency electromagnetic radiation (RF-EMR) induced possible health effects have emerged as a topic of recent day debate. The current study is designed to test the hypothesis that chronic 900MHz radiation exposure would potentially dysregulate the stress response system (HPA axis) in vivo, via, its non-thermal mechanisms, leading to alterations in the microarchitecture of the adrenal gland, vulnerable brain regions such as the hippocampus which may results in altered behaviours in rats. Male albino Wistar rats aged four weeks, weighing 50-60g were subjected to 900MHz radiation from a cellphone for four weeks at a rate of one hour per day.
View Article and Find Full Text PDFIdentifying the most effective acute stress induction methods for producing SAM- and HPA-related physiological responses: a meta-analysis.
Anxiety Stress Coping
January 2025
Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Background And Objectives: Laboratory-based stress inductions are commonly used to elicit acute stress but vary widely in their procedures and effectiveness. We compared the effects of stress induction techniques on measures of two major biological stress systems: the early sympathetic-adrenal-medullary (SAM) and the delayed hypothalamic-pituitary-adrenal (HPA) axis response.
Design: A review and meta-analysis to examine the relationship between stress induction techniques on cardiorespiratory and salivary measures of SAM and HPA system activity.
Acute and chronic cannabis vapor exposure influences basal and stress-induced release of glucocorticoids in male and female rats.
Psychoneuroendocrinology
December 2024
Hotchkiss Brain Institute, Mathison Centre for Mental Health Research and Education, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Cell Biology and Anatomy & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address:
Management of stress and anxiety is often listed as the primary motivation behind cannabis use. Human research has found that chronic cannabis use is associated with increased basal cortisol levels but blunted neuroendocrine responses to stress. Preclinical research has demonstrated mixed effects of Δ-tetrahydrocannabinol (THC; the psychoactive constituent of cannabis), much of which is suggestive of dose-dependent effects; however, the predominance of this work has employed an injection method to deliver cannabis.
View Article and Find Full Text PDFThe effect of mortality salience and early-life maternal care on neuroendocrine, autonomic, and psychological stress responses.
Sci Rep
January 2025
Department of Psychology, Division of Neuropsychology, University of Constance, Fach 905, Universitaetsstrasse 10, 78464, Constance, Germany.
Adverse early-life experiences alter the regulation of major stress systems such as the hypothalamic-pituitary-adrenal (HPA) axis. Low early-life maternal care (MC) has repeatedly been related to blunted cortisol stress responses. Likewise, an acutely increased awareness of mortality (mortality salience [MS]) also has been shown to blunt cortisol responses.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!