title: Predictors of Responses to Corticosteroids for Cancer-Related Fatigue in Advanced Cancer Patients: A Multicenter, Prospective, Observational Study.
abstract: Although corticosteroids are widely used to relieve cancer-related fatigue (CRF), information regarding the factors predicting responses to corticosteroids remains limited.
  
  
  
  The aim of this study was to identify potential factors predicting responses to corticosteroids for CRF in advanced cancer patients.
  
  
  
  Inclusion criteria for this multicenter, prospective, observational study were patients who had metastatic or locally advanced cancer and had a fatigue intensity score of 4 or more on a 0-10 Numerical Rating Scale (NRS). Univariate and multivariate analyses were conducted to identify the factors predicting two-point reduction or more in NRS on day 3.
  
  
  
  Among 179 patients who received corticosteroids, 86 (48%; 95% CI 41%-56%) had a response with two-point reduction or more. Factors that significantly predicted responses were performance status score of 3 or more, Palliative Performance Scale score more than 40, absence of ascites, absence of drowsiness, absence of depression, serum albumin level greater than 3 mg/dL, serum sodium level greater than 135 mEq/L, and baseline NRS score greater than 5. A multivariate analysis showed that the independent factors predicting responses were baseline NRS score greater than 5 (odds ratio [OR] 6.6, 95% CI 2.8-15.4), Palliative Performance Scale score more than 40 (OR 4.4, 95% CI 2.1-9.3), absence of drowsiness (OR 3.4, 95% CI 1.7-6.9), absence of ascites (OR 2.3, 95% CI 1.1-4.7), and absence of pleural effusion (OR 2.2, 95% CI 1.0-5.0).
  
  
  
  Treatment responses to corticosteroids for CRF may be predicted by baseline symptom intensity, performance status, drowsiness, and severity of fluid retention symptoms. Larger prospective studies are needed to confirm these results.
authors.affiliation: Hospice, Medical Corporation Junkei-kai Sotoasahikawa Hospital, Sotoasahikawa, Akita, Akita, Japan. Electronic address: matsuo@jkk-sotohp.or.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Matsuo
authors.affiliation: Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Osaka, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Palliative Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center, Shinjuku, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kaneishi
authors.affiliation: Komaki City Hospital, Komaki City, Aichi, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Odagiri
authors.affiliation: Department of Palliative Care and Pain Management, Cancer Institute Hospital, Koto-ku, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sakurai
authors.affiliation: NHO Yamaguchi-Ube Medical Center, Ube, Yamaguchi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Katayama
authors.affiliation: Gratia Hospital Hospice, Mino, Osaka, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Mori
authors.affiliation: Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Yamada
authors.affiliation: Komaki City Hospital, Komaki, Aichi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Palliative Medicine, Yokohama Municipal Citizens Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Kawasaki Municipal Ida Hospital, Kawasaki, Kanagawa, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nishi
authors.affiliation: Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Shirado
authors.affiliation: Department of Oncology, Mitsubishi Kyoto Hospital, Nisikyo-ku, Kyoto, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Hiramoto
authors.affiliation: Toyama Prefectural Central Hospital, Toyama, Toyama, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Palliative Care, Hiroshima Prefectural Hospital, Minami-ku, Hiroshima, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kohara
authors.affiliation: Department of Palliative Care, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya, Japan.
authors.forename: Satofumi
authors.initials: S
authors.lastname: Shimoyama
authors.affiliation: Department of Palliative Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Aruga
authors.affiliation: Palliative Care Division, Saito Yukoukai Hospital, Ibaragi, Osaka, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Baba
authors.affiliation: Matsue City Hospital, Matsue, Shimane, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Sumita
authors.affiliation: Research Hospital, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwase
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D005221:Fatigue / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D012894:Sleep Stages; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000697:Central Nervous System Stimulants
keywords: Fatigue; cancer; corticosteroids; palliative care; predictors