Lundström Staffan H, Fürst Carl Johan
Stockholms Sjukhem Foundation, Mariebergsgatan 22, S-11235 Stockholm, Sweden.
Acta Oncol. 2006;45(4):430-7. doi: 10.1080/02841860500401167.
Corticosteroids are commonly used in patients with advanced cancer on both specific and non-specific indications. They are potent drugs with potentially serious adverse side effects. We have in two separate surveys collected answers from 302 physicians and data from 1292 patients on corticosteroid prescription attitudes and clinical practice in Swedish palliative care. Corticosteroids were used in more than 50% of the cancer patients and with high response rates when treating appetite loss, nausea, fatigue or poor wellbeing. The positive response came within the first week of treatment and persisted beyond four weeks. Patients with prostate cancer had a significantly better treatment response of corticosteroids on fatigue as compared to patients with lung cancer. Few physicians had guidelines on the use of corticosteroids in advanced cancer and there were differences in the attitudes between different medical specialties. Guidelines based on prospective clinical trials are needed.
皮质类固醇常用于患有晚期癌症的患者，用于特定和非特定适应症。它们是强效药物，具有潜在的严重副作用。我们在两项独立调查中收集了302名医生的答案以及1292名患者关于瑞典姑息治疗中皮质类固醇处方态度和临床实践的数据。超过50%的癌症患者使用了皮质类固醇，在治疗食欲减退、恶心、疲劳或身体不适时反应率较高。积极反应在治疗的第一周内出现，并持续四周以上。与肺癌患者相比，前列腺癌患者使用皮质类固醇治疗疲劳的反应明显更好。很少有医生有晚期癌症使用皮质类固醇的指南，不同医学专科之间的态度存在差异。需要基于前瞻性临床试验的指南。
