PURPOSE Cerebral edema from brain tumors can cause neurological impairment. Steroids treat edema but with possible adverse effects. We surveyed providers regarding steroid use in newly diagnosed patients with brain tumors to determine if practices are standard or markedly variable. METHODS An anonymous voluntary online survey was sent to members of neuro-oncology consortiums. Four clinical scenarios were provided and questions regarding initiation of steroids, type, dose, formulation, and duration were asked. Demographic information was collected. RESULTS 369 providers received the survey, 76 responded (20.6% response rate). The proportion of providers who would start steroids significantly differed among scenarios (scenario 1 vs 2, p < 0.001; 2 vs 3, p < 0.001; 1 vs 3, p < 0.001). 75 (98.7%) providers would start steroids for vasogenic edema (scenario 1) and 55 (72.4%) for obstructive hydrocephalus (scenario 2). 16 (21.1%) would start steroids for vasogenic edema but not obstructive hydrocephalus. The odds of choosing to start steroids in patients with obstructive hydrocephalus were 7.59 times more (95% CI: 2.29, 25.13) if providers felt symptoms would improve within 24 h. All would use dexamethasone. A significant difference was seen between the proportion of providers who would give a loading dose if vasogenic edema with neurological deficits were noted versus vasogenic edema alone (57.9% vs 43.4%; p = 0.002). CONCLUSIONS These results suggest that providers recommend dexamethasone for patients with vasogenic edema and obstructive hydrocephalus. Variability remains with dosing schedule. Further studies are needed to identify the most appropriate use of steroids for newly diagnosed CNS tumor patients with the goal to create steroid management guidelines.

中文翻译：

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提供者对初诊小儿脑肿瘤患者围手术期使用类固醇的看法。

目的脑肿瘤引起的脑水肿可引起神经功能障碍。类固醇治疗水肿，但可能产生不良影响。我们就新诊断的脑肿瘤患者中类固醇的使用情况对提供者进行了调查，以确定操作是标准操作还是明显不同。方法将匿名的自愿在线调查发送给神经肿瘤学联盟的成员。提供了四种临床方案，并询问了有关类固醇起始，类型，剂量，制剂和持续时间的问题。收集了人口统计信息。结果369位提供者接受了调查，有76位回答（20.6％回复率）。在不同情况下，开始使用类固醇的提供者比例显着不同（情况1与2，p <0.001； 2与3，p <0.001； 1与3，p <0.001）。75（98。7％）的医疗服务提供者将开始使用类固醇治疗血管源性水肿（方案1），并使用55（72.4％）治疗阻塞性脑积水（方案2）。16（21.1％）会开始类固醇治疗血管性水肿，但不会阻塞性脑积水。如果提供者认为症状会在24小时内改善，则阻塞性脑积水患者选择开始使用类固醇的几率要高7.59倍（95％CI：2.29，25.13）。所有人都会使用地塞米松。在发现有神经系统缺陷的血管性水肿的情况下，提供负荷剂量的提供者比例与单独的血管性水肿之间存在显着差异（57.9％对43.4％； p = 0.002）。结论这些结果表明，提供者推荐地塞米松用于血管性水肿和阻塞性脑积水的患者。可变性仍然取决于给药时间表。