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From the Departments of Clinical Neurological Sciences, Diagnostic Radiology, and Radiation Oncology, University of Western Ontario and the London Regional Cancer Centre, London, Ontario, Canada.
The magnitude and time course of steroid-induced CT changes were analyzed in 11 patients with recurrent malignant glioma. CTs were obtained before and at regular intervals after starting dexamethasone (16 mg/d). Midline shift, ventricular compression, edema, enhancement intensity, and the size of the enhancing mass often improved with steroid treatment. Improvement occurred within 2 weeks in most instances. Changes in the volume of the enhancing tumor were assessed quantitatively in eight patients. In six, the mass was smaller after 2 weeks of steroid therapy, and in two the reduction approached 50%. Steroid-induced CT changes can mimic treatment responses. If steroids are necessary for symptom control, patients should be taking these medications for 2 weeks before a baseline CT is obtained and investigational treatment started.
Address correspondence and reprint requests to Dr. Cairncross, London Regional Cancer Centre, 391 South Street, London, Ontario, Canada N6A 4G5.
Received July 22, 1987. Accepted for publication in final form August 31, 1987.
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