From the Guidelines
Prednisone can be used during radiation therapy to reduce inflammation and manage side effects, with the decision made by the oncology team overseeing treatment. According to a recent study published in Neuro-Oncology in 2022 1, glucocorticoids, such as prednisone, are often used as first-line therapy in symptomatic patients with radiation necrosis. The study highlights the importance of managing radiation-induced inflammation and injury to the brain.
When considering the use of prednisone during radiation therapy, it is essential to weigh the benefits against the potential side effects, including increased blood sugar, fluid retention, mood changes, and increased infection risk. The medication is usually taken orally with food to minimize stomach irritation, often in the morning to mimic natural cortisol patterns. Typical doses range from 5-60 mg daily, depending on the specific condition being treated and the severity of symptoms.
In terms of managing side effects during radiation therapy, another study published in the Journal of Clinical Oncology in 2020 1 provides guidance on antiemetic administration, including the use of corticosteroids like dexamethasone. While this study focuses on antiemetic therapy, it underscores the importance of careful medication management during radiation treatment.
Key considerations for using prednisone during radiation therapy include:
- Careful monitoring of side effects and potential interactions with other medications
- Gradual tapering when discontinuing long-term use
- Informing all healthcare providers about prednisone use
- Close collaboration with the oncology team to determine the optimal treatment approach.
From the Research
Use of Prednisone During Radiation Therapy
- The use of prednisone during radiation therapy has been studied in various contexts, including its potential to prevent radiation-induced lung injury 2 and its interaction with immune checkpoint inhibitors 3.
- A study published in 1998 found that concurrent use of moderate-dose prednisone and azathioprine during radiation therapy did not prevent the development of radiation pneumonitis or bronchiolitis obliterans organizing pneumonia (BOOP) 2.
- Another study published in 2022 found that patients treated with immune checkpoint inhibitors and radiation therapy were not at increased risk of requiring corticosteroid therapy, but were at higher risk of hospitalization 3.
- The safety and effectiveness of corticosteroids, including prednisone, have also been reviewed in the context of joint pain treatment, with evidence suggesting moderate short-term benefits but potential adverse effects 4.
- A randomized controlled trial published in 2025 found that reduced elective dose in definitive radiotherapy for head and neck squamous cell carcinoma was safe and effective, but did not specifically address the use of prednisone during radiation therapy 5.
- A double-blind placebo-controlled randomized trial published in 1998 found that prednisone reduced the total duration of treatment and the total tumour and biologically effective dose in patients with head and neck cancer, but did not reduce the intensity or duration of mucositis 6.
Key Findings
- Prednisone may not prevent radiation-induced lung injury or radiation pneumonitis 2.
- The use of prednisone during radiation therapy may not increase the risk of requiring corticosteroid therapy, but may increase the risk of hospitalization 3.
- Corticosteroids, including prednisone, have potential adverse effects, including toxicity to articular cartilage and systemic side effects 4.
- Reduced elective dose in definitive radiotherapy for head and neck squamous cell carcinoma may be safe and effective, but the use of prednisone during radiation therapy requires further study 5.
- Prednisone may reduce the total duration of treatment and the total tumour and biologically effective dose in patients with head and neck cancer, but its effect on mucositis is unclear 6.