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Predictors of the Usefulness of Corticosteroids for Cancer-Related Fatigue in End-of-Life Patients

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Abstract

Background and Objectives

Although some studies have examined the use of corticosteroids, their effectiveness in treating cancer-related fatigue (CRF) has yet to be established. Therefore, this retrospective study attempted to identify factors that would predict the usefulness of corticosteroids in treating CRF.

Methods

We examined 87 hospitalized end-of-life cancer patients who were given betamethasone for relief of CRF at our hospital between January 2008 and January 2014. We evaluated the effect of betamethasone at 3 days after administration and performed a multivariate logistic regression analysis designed to identify predictive factors for the usefulness of corticosteroids. Threshold measurements were examined using a receiver operating characteristic (ROC) curve.

Results

This analysis identified the initial daily dose of betamethasone [odds ratio (OR) = 1.662], days from the start date of betamethasone administration to the date of death (OR = 1.05), administration of fentanyl (OR = 0.206) and age (OR = 1.055) as significant factors related to the effect of betamethasone. ROC curve analysis of the effect of the betamethasone showed that the threshold for the initial daily dose of betamethasone was above 4 mg, the threshold for the days from the start date of the betamethasone administration to the date of death was above 16 days and the threshold for age was above 60 years old.

Conclusion

The initial daily dose of betamethasone, days from the start date of the betamethasone administration to the date of death, non-administration of fentanyl and advanced age were shown to be predictive factors for the usefulness of corticosteroids for CRF in end-of-life patients.

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Authors and Affiliations

  1. Department of Hospital Pharmacy, University Hospital, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Yuko Kanbayashi

  2. Pain Treatment and Palliative Care Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Yuko Kanbayashi & Toyoshi Hosokawa

  3. Department of Pain Management and Palliative Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Toyoshi Hosokawa

Authors
  1. Yuko Kanbayashi
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  2. Toyoshi Hosokawa
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Correspondence to Yuko Kanbayashi.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent is not required for this type of study (restrospective nature).

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Kanbayashi, Y., Hosokawa, T. Predictors of the Usefulness of Corticosteroids for Cancer-Related Fatigue in End-of-Life Patients. Clin Drug Investig 37, 387–392 (2017). https://doi.org/10.1007/s40261-017-0493-4

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  • DOI: https://doi.org/10.1007/s40261-017-0493-4

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