THE ROLE OF STEROIDS IN THE MANAGEMENT OF METASTATIC CARCINOMA TO THEBRAIN - A PILOT PROSPECTIVE TRIAL

This prospective study attempted to evaluate the indications for gluco corticoids which are commonly given to patients with brain metastases. Twelve patients with histologically confirmed malignancies and radiog raphically documented brain metastases were enrolled. Patients were sc ored for general performance status and neurologic function class. All subjects were given high-dose dexamethasone (HDD) for 48 hours and th en randomized to receive either intermediate-dose dexamethasone (IDD) or no steroids with cranial radiotherapy. Of these 12 study patients, 3 achieved a complete response, 1 partial response, and 8 nonresponses to HDD. Seven patients had IDD, while five received no IDD. Although a small sample size prevented any statistical analysis, this study doe s suggest that the place for using glucocorticoids in treating patient s with metastatic carcinoma to the brain remains uncertain and should be evaluated in a cooperative prospective trial.