title: Use of corticosteroids for pain control in cancer patients with bone metastases: a comprehensive literature review.
abstract: Despite a limited understanding of the exact mechanism, corticosteroids are commonly employed for pain control in patients with bone metastases. The aim of this review was to evaluate the efficacy of corticosteroid-mediated pain control in patients with bone metastases associated with solid cancers.
  
  
  
  A literature search was conducted using OVID MEDLINE and Embase databases (from 1946 up to July 19, 2016). Studies involving patients with bone metastases receiving corticosteroids as the primary means of pain control were included. Screening and data extraction were conducted by paired reviewers, with consensus established by discussion, or a third adjudicator. A total of 12 studies were included. Rates of pain relief achieved with corticosteroid use varied from 30 to 70%, but generally reflected moderate pain control. Corticosteroid use significantly reduced the incidence of pain flare alongside radiotherapy, reportedly by almost half of baseline pain severity. Adverse events were not documented consistently across studies, though grade two to three hyperglycemia was noted in approximately 2% of patients by some studies.
  
  
  
  Recent evidence suggests that short-term corticosteroid use may provide moderate pain and pain flare control with radiotherapy for patients with bone metastases. The risk of developing adverse effects should be carefully considered prior to therapy initiation on a case-by-case basis.
authors.affiliation: aDepartment of Oncology, Princess Margaret Hospital, Hong Kong bDivision of Experimental Medicine, Faculty of Medicine, McGill University, Montréal, Quebec cSchool of Medicine, University of Toronto, Toronto, Ontario, Canada dRadiation Oncology Unit, Hospital de Caridade Astrogildo de Azevedo eRadiation Oncology Unit, Santa Maria Federal University, Santa Maria, Brazil.
authors.forename: Fiona M Y
authors.initials: FMY
authors.lastname: Lim
authors.forename: Adam
authors.initials: A
authors.lastname: Bobrowski
authors.forename: Arnav
authors.initials: A
authors.lastname: Agarwal
authors.forename: Mauricio F
authors.initials: MF
authors.lastname: Silva
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary*; D000072716:Cancer Pain / Q000188:drug therapy* / Q000532:radiotherapy; D004359:Drug Therapy, Combination; D006801:Humans; D059408:Pain Management / Q000379:methods
chemical_list: D000305:Adrenal Cortex Hormones; D000701:Analgesics, Opioid