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Updated: Dec 25, 2025

The Clinical Application of Tumor Treating Fields Therapy in Glioblastoma
Published on: April 16, 2019
Prolonged Steroid Dependence in Adult Patients With Glioma
Emmanuel C Mantilla1, Jessica Abramowitz2, T U Dan3
1Department of Oncology, John Peter Smith Health Network, Fort Worth, TX, U.S.A. emantill@jpshealth.org.
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.
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