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January 22, 2019

Dexamethasone—Friend or Foe for Patients With Glioblastoma?

Author Affiliations
  • 1Brain Tumor Center, Neuro-Oncology Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
JAMA Neurol. 2019;76(3):247-248. doi:10.1001/jamaneurol.2018.4530

Dexamethasone is a synthetic corticosteroid with a broad range of biologic effects, including strong anti-inflammatory activity. It has been used to treat cerebral edema in patients with glioblastoma since its introduction by Lyle French, MD, PhD, and Joseph Galicich, MD, in the early 1960s. At that time, the dosage was empirically determined and set at a 10-mg bolus followed by a maintenance dose of 4 mg every 6 hours, with a physician’s choice of tapering. This has become a standard of care for patients found to have a brain tumor. However, recent laboratory and clinical data have revealed that dexamethasone can be both helpful and detrimental, depending on the clinical context.