Practical Review of Role and Usage of Corticosteroids in Modern Neuro-Oncology Care

This practical review recommends corticosteroids only as a temporary measure for mass effect in neuro-oncology patients, at the lowest effective dose once or twice daily (the second dose no later than early afternoon), tapered off as soon as possible. Long-term use increases adverse effects across endocrine, immune, dermatologic, gastrointestinal, orthopedic, and neuropsychiatric systems, and weakens the efficacy of immunotherapy and chemoradiation. Steroid-sparing options such as bevacizumab have been used to reduce toxicity, and steroid effects on tumor response are now formally incorporated into imaging response assessment.