Steroid-sparing effects of angiotensin-II inhibitors in glioblastoma patients
| Autor: | Olivier Bailon, Catherine Belin, Antoine F. Carpentier, Daniela Ferrari, C. Banissi, A.-L. Dubessy, Renata Ursu, C. Levy |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Adolescent Angiogenesis medicine.medical_treatment Brain tumor Angiotensin-Converting Enzyme Inhibitors Brain Edema Young Adult chemistry.chemical_compound Adrenal Cortex Hormones Internal medicine medicine Humans Prospective cohort study Aged Retrospective Studies Aged 80 and over Temozolomide Performance status Brain Neoplasms business.industry Angiotensin II Chemoradiotherapy Middle Aged medicine.disease Surgery Vascular endothelial growth factor Radiation therapy Neurology chemistry Female Neurology (clinical) Glioblastoma business medicine.drug |
| Zdroj: | European Journal of Neurology. 19:1337-1342 |
| ISSN: | 1351-5101 |
| DOI: | 10.1111/j.1468-1331.2012.03766.x |
| Popis: | Background The standard of care in patients with glioblastoma (GBM) relies on surgical resection, radiation therapy (RT), and temozolomide. Steroids are required in almost all patients to reduce peritumoral edema, but are associated with numerous side effects. Vascular endothelial growth factor (VEGF) is a key driver of peritumoral edema and angiogenesis in human GBM. Recently, angiotensin-II inhibitors were reported to reduce VEGF secretion and tumor growth in some animal models. Methods To investigate whether angiotensin-II inhibitors might have a similar effect in humans and before undertaking a prospective study, we retrospectively investigated a series of 87 consecutive, newly diagnosed GBM patients, treated in a single center. Amongst these patients, 29 (33%) were already treated before RT for high blood pressure (HBP), 18 of them (21%) with an angiotensin-II inhibitor. In all patients, performance status, surgical procedures, and steroid dosages were documented. Results Patients treated with angiotensin-II inhibitors, but not other antihypertensive drugs, required half of the steroids of the other patients during radiotherapy (P = 0.005 in multivariate analysis, considering other antihypertensive treatments, surgical resection, and performance status). This effect of angiotensin-II inhibitors was also significant at the beginning of radiotherapy (P = 0.03 in multivariate analysis). Treatment with angiotensin-II inhibitors had no effect on survival (16.2 vs. 17.9 months for the treated and the non-treated group, respectively, P = 0.77). Conclusion Angiotensin-II inhibitors might display significant steroid-sparing effects in brain tumor patients. Given the morbidity associated with steroids, this finding might have important practical consequences in these patients and warrants a randomized study. |
| Databáze: | OpenAIRE |
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