Symptomatic Treatment and Supportive Care

Chapter 4 - Treatment Strategies for Anaplastic Astrocytoma and Glioblastoma

Corticosteroids are powerful anti-oedema agents in brain tumour patients. 

Chronic exposure to corticosteroids has a broad range of side effects.

Anti-VEGF agents have strong steroid-sparing properties.

Symptomatic Treatment Supportive Care Figure 2

Courtesy C. Happold, Zurich

Approximately 50% of affected patients develop symptomatic epilepsy.

The choice of antiepileptic drug needs to consider the high risk of cognitive side effects and drug–drug interactions.

Levetiracetam, lamotrigine and pregabalin, for example, have a favourable benefit-risk profile in brain tumour patients.

Deep vein thrombosis or pulmonary embolism may affect more than 50% of patients.

Symptomatic Treatment Supportive Care Figure 3

Courtesy A. Valavanis, Zurich

Interactions of novel drugs, notably Antiangiogenic agents, and antiplatelet agents and anticoagulants require consideration.

Neurorehabilitation assumes increasing importance as the number of long-term surviving patients increases.

Revision Questions

  1. What is the mode of action of corticosteroids in brain tumour patients?
  2. What are the antiepileptic drugs of choice in brain tumour patients?
  3. What are the most common cardiovascular complications in brain tumour patients?

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Last update: 18 September 2017