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Clinical Case Report
Avoiding Glucocorticoid Administration in a Neurooncological Case
Hans Peter Rutz, Silvia Hofer, Pietro E. Peghini, Ursula Gutteck-Amsler, Katharina Rentsch, Peter J. Meier-Abt, Urs R. Meier and René Ludwig Bernays
volume 4 | issue 11
november 2005Pages: 1186-1189
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Restricting glucocorticoid (GC) use in the treatment of patients with a solid tumor may help improving outcome. Here, we report administration of celecoxib rather than dexamethasone to prevent brain edema in a patient with a cerebellar glioblastoma multiforme WHO grade IV (GBM) upon the patient’s request, as well as determining cerebrospinal fluid (CSF) and serum concentrations. CSF concentration (0.04 ?M) was 54 times below serum concentration (2.18 ?M), or 2500 times below levels inhibiting GBM cells in vitro (100 ?M), revealing a blood CSF barrier for celecoxib. The patient did not require dexamethasone for the entire treatment. GC administration hence was avoided successfully in this case. The role of COX-2 inhibitors in treatment of GBM is detailed, leading to the conclusion of a pressing need for a clinical evaluation of non-steroidal COX-2 inhibitors with the ability to penetrate into brain tumors.
We now provide open access to journal articles published online for one year or more. This article may be downloaded at the following link:
Download PDFIf the document does not open, please right-click on the link (control-click on a Macintosh) and select the option to save the file to disk.