{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T15:11:05Z","timestamp":1778253065462,"version":"3.51.4"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Corticosteroids are used routinely in pediatric patients with central nervous system tumors. However, the efficacy profiles of these medications, prevalence of adverse effects, dosing schedules, and impact on patients\u2019 quality-of-life are poorly elucidated. The aim of this study was to identify, appraise, and synthesize available international evidence regarding the role of corticosteroids in the symptom management of pediatric neuro-oncology patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A rapid review of articles studying the role of corticosteroids in pediatric neuro-oncology was undertaken in August 2024. This study is reported using the PRISMA statement and was registered with PROSPERO (CRD42024567489). Five databases were searched, and data were analyzed using narrative synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 1935 identified papers, 9 met the inclusion criteria (n\u2009=\u20096 retrospective cohort studies and n\u2009=\u20093 survey studies). Four key themes were identified in this rapid review: (1) variability in indication, dosing schedules, and prescribing practices for corticosteroids; (2) limited evidence available regarding symptomatic benefits from corticosteroid use; (3) adverse effects from prolonged corticosteroid use; and (4) clinicians recommend consensus guidelines to inform corticosteroid prescribing practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As the first review utilizing systematic methodology exploring the topic of corticosteroid use in pediatric neuro-oncology, we identified a paucity of pediatric studies addressing corticosteroid efficacy. Dosing is variable, adverse effects are duration-dependent and multi-system and there is an urgent need for the development of guidelines to inform best practice. High-income countries and inpatient perioperative settings dominate the published literature. There is an absence of consumer voices addressing the impact on quality-of-life from corticosteroid use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/nop\/npaf097","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T11:56:56Z","timestamp":1757678216000},"page":"227-237","source":"Crossref","is-referenced-by-count":0,"title":["Corticosteroid use in pediatric neuro-oncology symptom management: A rapid review"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2914-8637","authenticated-orcid":false,"given":"Neevika","family":"Manoharan","sequence":"first","affiliation":[{"name":"Kids Cancer Centre, Sydney Children\u2019s Hospital , Randwick,","place":["Australia"]},{"name":"School of Women\u2019s and Children\u2019s Health, UNSW Sydney , Kensington,","place":["Australia"]},{"name":"Children\u2019s Cancer Institute , Kensington,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Armitage","sequence":"additional","affiliation":[{"name":"School of Women\u2019s and Children\u2019s Health, UNSW Sydney , Kensington,","place":["Australia"]},{"name":"Department of Palliative Care, Sydney Children\u2019s Hospital , Randwick,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Virdun","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences, Flinders University , Adelaide,","place":["Australia"]},{"name":"Flinders Research Centre for Palliative Care, Death and Dying, Flinders University , Adelaide,","place":["Australia"]},{"name":"Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology (QUT) , Brisbane,","place":["Australia"]},{"name":"Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS) , Sydney,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"2026050810214401300_npaf097-B1","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/S1470-2045(17)30186-9","article-title":"International incidence of childhood cancer, 2001-10: a population-based registry study","volume":"18","author":"Steliarova-Foucher","year":"2017","journal-title":"Lancet Oncol"},{"key":"2026050810214401300_npaf097-B2","doi-asserted-by":"crossref","first-page":"2716","DOI":"10.1158\/1055-9965.EPI-14-0207","article-title":"Childhood brain tumor epidemiology: a brain tumor epidemiology consortium review","volume":"23","author":"Johnson","year":"2014","journal-title":"Cancer Epidemiol Biomarkers Prev."},{"key":"2026050810214401300_npaf097-B3","doi-asserted-by":"crossref","first-page":"iii1","DOI":"10.1093\/neuonc\/noac161","article-title":"CBTRUS statistical report: pediatric brain tumor foundation childhood and adolescent primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018","volume":"24","author":"Ostrom","year":"2022","journal-title":"Neuro Oncol"},{"key":"2026050810214401300_npaf097-B4","doi-asserted-by":"crossref","first-page":"101942","DOI":"10.1016\/j.canep.2021.101942","article-title":"Epidemiology and prognostic factors of pediatric brain tumor survival in the US: evidence from four decades of population data","volume":"72","author":"Hossain","year":"2021","journal-title":"Cancer Epidemiol."},{"key":"2026050810214401300_npaf097-B5","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1177\/0883073815597756","article-title":"Improving care in pediatric neuro-oncology patients: an overview of the unique needs of children with brain tumors","volume":"31","author":"Fischer","year":"2016","journal-title":"J Child Neurol."},{"key":"2026050810214401300_npaf097-B6","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1093\/neuonc\/noy056","article-title":"Corticosteroid use endpoints in neuro-oncology: response assessment in Neuro-Oncology Working Group","volume":"20","author":"Arvold","year":"2018","journal-title":"Neuro Oncol."},{"key":"2026050810214401300_npaf097-B7","doi-asserted-by":"crossref","first-page":"655","DOI":"10.4187\/respcare.06314","article-title":"Clinical pharmacology of corticosteroids","volume":"63","author":"Williams","year":"2018","journal-title":"Respir Care."},{"key":"2026050810214401300_npaf097-B8","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1056\/NEJM195204102461502","article-title":"Cortisone and ACTH as an adjunct to the surgery of craniopharyngiomas","volume":"246","author":"Ingraham","year":"1952","journal-title":"N Engl J Med."},{"key":"2026050810214401300_npaf097-B9","first-page":"46","article-title":"Use of dexamethasone in treatment of cerebral edema associated with brain tumors","volume":"81","author":"Galicich","year":"1961","journal-title":"J Lancet."},{"key":"2026050810214401300_npaf097-B10","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1007\/s00381-022-05569-6","article-title":"A 10-year retrospective observational study on the utility and prescription standards of dexamethasone in pediatric neuro-oncosurgery in a tertiary care center","volume":"38","author":"Ayudhaya","year":"2022","journal-title":"Childs Nervous System"},{"key":"2026050810214401300_npaf097-B11","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S1470-2045(07)70207-3","article-title":"Presentation of childhood CNS tumours: a systematic review and meta-analysis","volume":"8","author":"Wilne","year":"2007","journal-title":"Lancet Oncol."},{"key":"2026050810214401300_npaf097-B12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/0885066615619618","article-title":"Critical care management of cerebral edema in brain tumors","volume":"32","author":"Esquenazi","year":"2017","journal-title":"J Intensive Care Med."},{"key":"2026050810214401300_npaf097-B13","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.iac.2005.05.003","article-title":"Molecular mechanisms and cellular effects of glucocorticosteroids","volume":"25","author":"Barnes","year":"2005","journal-title":"Immunol Allergy Clin North Am."},{"key":"2026050810214401300_npaf097-B14","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s11060-016-2141-x","article-title":"State of affairs in use of steroids in diffuse intrinsic pontine glioma: an international survey and a review of the literature","volume":"128","author":"Veldhuijzen van Zanten","year":"2016","journal-title":"J Neurooncol."},{"key":"2026050810214401300_npaf097-B15","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.2217\/fon-2021-1455","article-title":"Palliative and end-of-life symptoms management for children with diffuse intrinsic pontine glioma","volume":"18","author":"Elhemaly","year":"2022","journal-title":"Future Oncol."},{"key":"2026050810214401300_npaf097-B16","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1002\/pbc.25160","article-title":"End-of-life care in pediatric neuro-oncology","volume":"61","author":"Vallero","year":"2014","journal-title":"Pediatr Blood Cancer."},{"key":"2026050810214401300_npaf097-B17","doi-asserted-by":"crossref","first-page":"101098","DOI":"10.1016\/j.neo.2024.101098","article-title":"Pediatric neuro-oncology: highlights of the last quarter-century","volume":"59","author":"Power","year":"2025","journal-title":"Neoplasia."},{"key":"2026050810214401300_npaf097-B18","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4939-1541-5","volume-title":"Pediatric Neuro-Oncology","author":"Scheinemann","year":"2015"},{"key":"2026050810214401300_npaf097-B19","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/978-1-59259-317-0_3","volume-title":"Cancer Neurology in Clinical Practice","author":"Paleologos","year":"2003"},{"key":"2026050810214401300_npaf097-B20","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s11060-016-2219-5","article-title":"Treatment of pediatric cerebral radiation necrosis: a systematic review","volume":"130","author":"Drezner","year":"2016","journal-title":"J Neurooncol."},{"key":"2026050810214401300_npaf097-B21","doi-asserted-by":"crossref","first-page":"3417","DOI":"10.1200\/JCO.2016.66.4789","article-title":"Behavioral, social, and emotional symptom comorbidities and profiles in adolescent survivors of childhood cancer: a report from the childhood cancer survivor study","volume":"34","author":"Brinkman","year":"2016","journal-title":"J Clin Oncol."},{"key":"2026050810214401300_npaf097-B22","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.clnu.2014.01.013","article-title":"Changes in nutritional status in childhood cancer patients: a prospective cohort study","volume":"34","author":"Brinksma","year":"2015","journal-title":"Clin Nutr."},{"key":"2026050810214401300_npaf097-B23","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1158\/1055-9965.EPI-13-0610","article-title":"Impact of treatment exposures on cardiovascular risk and insulin resistance in childhood cancer survivors","volume":"22","author":"Baker","year":"2013","journal-title":"Cancer Epidemiol Biomarkers Prev."},{"key":"2026050810214401300_npaf097-B24","doi-asserted-by":"crossref","first-page":"1551111","DOI":"10.3389\/fphar.2025.1551111","article-title":"Rethinking corticosteroids use in oncology","volume":"16","author":"Martinez","year":"2025","journal-title":"Front Pharmacol."},{"key":"2026050810214401300_npaf097-B25","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1097\/MPH.0b013e318257fdac","article-title":"Corticosteroids, behavior, and quality of life in children treated for acute lymphoblastic leukemia; a multicentered trial","volume":"34","author":"Pound","year":"2012","journal-title":"J Pediatr Hematol Oncol."},{"key":"2026050810214401300_npaf097-B26","first-page":"817","volume-title":"Mayo Clinic Proceedings","author":"Drozdowicz","year":"2014"},{"key":"2026050810214401300_npaf097-B27","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1007\/s00234-024-03493-x","article-title":"Response assessment in pediatric neurooncology (RAPNO) criteria revisited: a practical navigation guide for neuroradiologists","volume":"66","author":"Geraldo","year":"2024","journal-title":"Neuroradiology."},{"key":"2026050810214401300_npaf097-B28","doi-asserted-by":"crossref","first-page":"e317","DOI":"10.1016\/S1470-2045(20)30173-X","article-title":"Response assessment in paediatric high-grade glioma: recommendations from the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group","volume":"21","author":"Erker","year":"2020","journal-title":"Lancet Oncol."},{"key":"2026050810214401300_npaf097-B29","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jclinepi.2020.09.041","article-title":"Defining rapid reviews: a systematic scoping review and thematic analysis of definitions and defining characteristics of rapid reviews","volume":"129","author":"Hamel","year":"2021","journal-title":"J Clin Epidemiol."},{"key":"2026050810214401300_npaf097-B30","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/1748-5908-5-56","article-title":"Expediting systematic reviews: methods and implications of rapid reviews","volume":"5","author":"Ganann","year":"2010","journal-title":"Implement Sci."},{"key":"2026050810214401300_npaf097-B31","article-title":"Guidance on the conduct of narrative synthesis in systematic reviews","author":"Popay","year":"2006","journal-title":"ESRC Methods Programme"},{"key":"2026050810214401300_npaf097-B32","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1111\/jep.12884","article-title":"Improving the usefulness of a tool for appraising the quality of qualitative, quantitative and mixed methods studies, the mixed methods appraisal tool (MMAT)","volume":"24","author":"Hong","year":"2018","journal-title":"J Eval Clin Pract."},{"key":"2026050810214401300_npaf097-B33","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ijnurstu.2011.07.002","article-title":"Testing the reliability and efficiency of the pilot mixed methods appraisal tool (MMAT) for systematic mixed studies review","volume":"49","author":"Pace","year":"2012","journal-title":"Int J Nurs Stud."},{"key":"2026050810214401300_npaf097-B34","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/1471-2288-8-45","article-title":"Methods for the thematic synthesis of qualitative research in systematic reviews","volume":"8","author":"Thomas","year":"2008","journal-title":"BMC Med Res Methodol."},{"key":"2026050810214401300_npaf097-B35","doi-asserted-by":"crossref","first-page":"3669","DOI":"10.1007\/s00381-021-05354-x","article-title":"Perioperative corticosteroid use in paediatric neuro-oncology","volume":"37","author":"Carruthers","year":"2021","journal-title":"Childs Nerv Syst."},{"key":"2026050810214401300_npaf097-B36","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1136\/adc.76.1.76","article-title":"Corticosteroids in the management of central nervous system tumours. Kids Neuro-Oncology Workshop (KNOWS)","volume":"76","author":"Glaser","year":"1997","journal-title":"Arch Dis Child."},{"key":"2026050810214401300_npaf097-B37","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1002\/ijc.34399","article-title":"Evaluating the safety of perioperative dexamethasone treatment: a retrospective analysis of a single center pediatric low-grade glioma cohort","volume":"152","author":"Gorodezki","year":"2023","journal-title":"Int J Cancer."},{"key":"2026050810214401300_npaf097-B38","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1080\/02688697.2022.2040948","article-title":"Pre-operative dosing of dexamethasone for the management of children with posterior fossa tumours: are we getting it right?","volume":"36","author":"Makwana","year":"2022","journal-title":"Br J Neurosurg."},{"key":"2026050810214401300_npaf097-B39","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s11060-020-03416-9","article-title":"Provider views on perioperative steroid use for patients with newly diagnosed pediatric brain tumors","volume":"147","author":"Malbari","year":"2020","journal-title":"J Neurooncol."},{"key":"2026050810214401300_npaf097-B40","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1055\/s-2003-42722","article-title":"Perioperative dexamethasone treatment in childhood craniopharyngioma\u2014influence on short-term and long-term weight gain","volume":"111","author":"M\u00fcller","year":"2003","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"2026050810214401300_npaf097-B41","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s11060-016-2363-y","article-title":"Development of the SIOPE DIPG network, registry and imaging repository: a collaborative effort to optimize research into a rare and lethal disease","volume":"132","author":"Veldhuijzen van Zanten","year":"2017","journal-title":"J Neurooncol"},{"key":"2026050810214401300_npaf097-B42","doi-asserted-by":"crossref","first-page":"494","DOI":"10.3171\/2020.11.PEDS20842","article-title":"Standardization of dexamethasone utility in pediatric neuro-oncosurgery","volume":"27","author":"Morrison","year":"2021","journal-title":"J Neurosurg Pediatr"},{"key":"2026050810214401300_npaf097-B43","doi-asserted-by":"crossref","first-page":"4762","DOI":"10.1200\/JCO.2010.30.3545","article-title":"Phase I study of vandetanib during and after radiotherapy in children with diffuse intrinsic pontine glioma","volume":"28","author":"Broniscer","year":"2010","journal-title":"J Clin Oncol."},{"key":"2026050810214401300_npaf097-B44","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1586\/ecp.11.1","article-title":"Corticosteroids in brain cancer patients: benefits and pitfalls","volume":"4","author":"Dietrich","year":"2011","journal-title":"Expert Rev Clin Pharmacol."},{"key":"2026050810214401300_npaf097-B45","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1136\/jnnp.2003.028647","article-title":"Effects of dexamethasone on peritumoural oedematous brain: a DT-MRI study","volume":"75","author":"Sinha","year":"2004","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"2026050810214401300_npaf097-B46","first-page":"322","article-title":"Dexamethasone treatment in patients with brain metastases and primary brain tumors: do the benefits outweigh the side-effects?","volume":"10","author":"Hempen","year":"2002","journal-title":"Support Care Cancer."},{"key":"2026050810214401300_npaf097-B47","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s11060-012-0919-z","article-title":"Steroid psychosis: a review for neurosurgeons","volume":"109","author":"Ross","year":"2012","journal-title":"J Neurooncol."},{"key":"2026050810214401300_npaf097-B48","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1212\/WNL.41.8.1235","article-title":"Steroid-induced weakness in patients with primary brain tumors","volume":"41","author":"Dropcho","year":"1991","journal-title":"Neurology."},{"key":"2026050810214401300_npaf097-B49","first-page":"6","article-title":"Corticosteroid use in neuro-oncology: an update","volume":"2","author":"Roth","year":"2015","journal-title":"Neurooncol Pract."},{"key":"2026050810214401300_npaf097-B50","doi-asserted-by":"crossref","first-page":"ii26","DOI":"10.1093\/neuonc\/nov270","article-title":"Report of the jumpstarting brain tumor drug development coalition and FDA clinical trials clinical outcome assessment endpoints workshop","volume":"18","author":"Helfer","year":"2016","journal-title":"Neuro Oncol"},{"key":"2026050810214401300_npaf097-B51","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jclinepi.2021.03.001","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"134","author":"Page","year":"2021","journal-title":"J Clin Epidemiol."},{"key":"2026050810214401300_npaf097-B52","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2217\/cns-2016-0016","article-title":"Clinical trials in pediatric neuro-oncology: what is missing and how we can improve","volume":"5","author":"Byer","year":"2016","journal-title":"CNS Oncol."},{"key":"2026050810214401300_npaf097-B53","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jclinepi.2013.12.002","article-title":"Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies","volume":"67","author":"Diamond","year":"2014","journal-title":"J Clin Epidemiol."}],"container-title":["Neuro-Oncology Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/nop\/advance-article-pdf\/doi\/10.1093\/nop\/npaf097\/64302575\/npaf097.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/nop\/article-pdf\/13\/2\/227\/64302575\/npaf097.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/nop\/article-pdf\/13\/2\/227\/64302575\/npaf097.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T14:21:54Z","timestamp":1778250114000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/nop\/article\/13\/2\/227\/8256737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":53,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,9,17]]},"published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/nop\/npaf097","relation":{},"ISSN":["2054-2577","2054-2585"],"issn-type":[{"value":"2054-2577","type":"print"},{"value":"2054-2585","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2025,9,17]]}}}