title: Predictors of responses to corticosteroids for anorexia in advanced cancer patients: a multicenter prospective observational study.
abstract: Although corticosteroids are widely used to relieve anorexia, information regarding the factors predicting responses to corticosteroids remains limited. The purpose of the study is to identify potential factors predicting responses to corticosteroids for anorexia in advanced cancer patients.
  
  
  
  Inclusion criteria for this multicenter prospective observational study were patients who had metastatic or locally advanced cancer and had an anorexia 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 ≥2-point reduction in NRS on day 3.
  
  
  
  Among 180 patients who received corticosteroids, 99 (55 %; 95 % confidence interval [CI], 47-62 %) had a response with ≥2-point reduction. Factors that significantly predicted responses were Palliative Performance Scale (PPS) > 40 and absence of drowsiness. In addition, factors that tended to be associated with ≥2-point reduction in NRS included PS 0-3, absence of diabetes mellitus, absence of peripheral edema, presence of lung metastasis, absence of peritoneal metastasis, baseline anorexia NRS of >6, presence of pain, and presence of constipation. A multivariate analysis showed that the independent factors predicting responses were PPS of >40 (odds ratio = 2.7 [95 % CI = 1.4-5.2]), absence of drowsiness (2.6 [1.3-5.0]), and baseline NRS of >6 (2.4 [1.1-4.8]).
  
  
  
  Treatment responses to corticosteroids for anorexia may be predicted by PPS, drowsiness, and baseline symptom intensity. Larger prospective studies are needed to confirm these results.
authors.affiliation: Hospice, Medical Corporation Junkei-kai Sotoasahikawa Hospital, 42, Aza-Sangoden, Sotoasahikawa, Akita, Akita, 010-0802, Japan. 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, 3453 Mikatahara-cho, Kita-ku, Hamamatsu, Shizuoka, 433-8558, 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, 591-8555, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Palliative Medicine, Showa University Northern Yokohama Hospital, 35-1 Chigasaki Chuo Tsuduki-ku, Yokohama, Kanagawa, 224-8503, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center, 5-1 Tsukudo-cho, Shinjuku, Tokyo, 162-0815, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kaneishi
authors.affiliation: Komaki City Hospital, 1-20 Jobushi, Komaki-city, Aichi, 485-8520, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Odagiri
authors.affiliation: Department of Palliative Care and Pain Management, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sakurai
authors.affiliation: NHO Yamaguchi-Ube Medical Center, 685, Higashi-Kiwa, Ube, Yamaguchi, 755-0241, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Katayama
authors.affiliation: Gratia Hospital Hospice, 6-14-1 Aomadaninishi, Mino, Osaka, 562-8567, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Mori
authors.affiliation: Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Yamada
authors.affiliation: Komaki City Hospital, 1-20 Jobushi, Komaki, Aichi, 485-8520, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Palliative Medicine, Yokohama Municipal Citizens Hospital, 56, Okazawa-cho, Hodogaya-ku, Yokohama, Kanagawa, 240-8555, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Palliative Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunokicho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Kawasaki Municipal Ida Hospital, Nakahara-ku Ida, Kawasaki, Kanagawa, 2-27-1, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nishi
authors.affiliation: Seirei Mikatahara General Hospital, 3453, Mikatahara-Cho, Kita-Ku, Hamamatsu, Shizuoka, 433-8558, Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Shirado
authors.affiliation: Department of Oncology, Mitsubishi Kyoto Hospital, Katsura Goshocho1, Nisikyo-ku, Kyoto, 615-8087, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Hiramoto
authors.affiliation: Toyama Prefectural Central Hospital, 2-2-78, Nishinagae, Toyama, Toyama, 930-8550, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Palliative Care, Hiroshima Prefectural Hospital, 1-5-54, Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kohara
authors.affiliation: Department of Palliative Care, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Satofumi
authors.initials: S
authors.lastname: Shimoyama
authors.affiliation: Department of Palliative Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Aruga
authors.affiliation: Palliative Care Division, Saito Yukoukai Hospital, 7-2-18 Saito Asagi, Ibaragi, Osaka, 567-0085, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Baba
authors.affiliation: Matsue City Hospital, 32-1, Noshira-cho, Matsue, Shimane, 690-8509, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Sumita
authors.affiliation: Research Hospital, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwase
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care / Q000379:methods*
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Anorexia; Cancer; Corticosteroids; Palliative care; Predictors