BMC Cancer 2008, 8:84 http://www.biomedcentral.com/1471-2407/8/84 Table 10: Randomized Controlled Trial of Glucocorticoids in Primary CNS Neoplasms Author [reference], Year Patient Characteristics Treatment Arms Patient Number (Randomized/Evaluable) Quality Score Outcome(s) Green et al [23], 1983 after surgery for supratentorial BCNU 80 mg/m2/day IV for 3 consecutive malignant glioma; 6000 rads of days every 8 weeks (147/124) vs. radiation to start concurrently with methylprednisolone 400 mg/m2/day orally medical therapy for 7 consecutive days every 4 weeks (156/ 141) vs. BCNU + methylprednisolone as previously described (153/134) vs. procarbazine 150 mg/m2/day orally for 28 consecutive days every 8 weeks (153/128) 2 24 month survivals of 19.5% vs. 8.0% vs. 18.0% vs. 22.2%; in pairwise comparisons, only differences giving p < 0.05 were BCNU vs. methylprednisolone and procarbazine vs. methylprednisolone group of patients with very advanced cancer; no patient lived longer than 45 days [61]. There is a meta-analysis of three small RCTs of glucocorti- coids in patients with bowel obstruction secondary to malignancy. The treatment period in these 3 trials lasted from 3–10 days; after the treatment period, glucocorti- coids were not prohibited. There was no survival differ- ence [62]. There are two trials of chemotherapy +/- glucocorticoids. In the older of these two trials, glucocorticoids had a neu- tral effect. In this trial, the remission criteria are not read- ily comparable to those presently used [27]. In the second trial, glucocorticoids ameliorated the GI toxicity of perifo- sine resulting in longer duration of treatment in the gluco- corticoid arm: glucocorticoids may have acted as a chemoprotective agent [52]. Finally, there is one trial of radiation +/- glucocorticoids in patients with epidural metastases of a carcinoma com- pressing the spinal cord or cauda equina [29]; there is a second trial comparing two doses of glucocorticoids in patients with spinal cord compression [57]. In both of these trials, a large proportion of patients had breast or prostate cancer. There was no survival difference in either trial. About the quality of the meta-analysis, the inclusion crite- ria were objective and explicit. The literature search was thorough. There was quality assessment of the clinical tri- als that made up the meta-analysis. There was independ- ent data abstraction by two reviewers. Individual patient data was used to obtain survival analysis. However, the meta-analysis is based on the results of 83 patients [62]. A description of these trials and the meta-analysis is given in Table 11. FFoigruesrteP5lot of Eight Week Mortality Rates in Two Trials of Glucocorticoid Monotherapy in Nonhematologic Malignancy Forest Plot of Eight Week Mortality Rates in Two Trials of Glucocorticoid Monotherapy in Nonhematologic Malignancy. Page 12 of 19 (page number not for citation purposes)