Yennurajalingam Sriram, Bruera Eduardo
From the Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Cancer J. 2014 Sep-Oct;20(5):319-24. doi: 10.1097/PPO.0000000000000069.
Cancer-related fatigue (CRF) is the most common and debilitating symptom in patients with cancer. Currently, there are very limited pharmacological interventions to effectively treat CRF. In this article, the authors review various pharmacological interventions for CRF and propose future direction for further research. Methylphenidate is the most studied pharmacological agent for the treatment of CRF. Various pharmacological studies have suggested benefit of corticosteroids, especially in terminally ill patients for a short period. However, recent systematic reviews, meta-analyses, and guidelines recommend caution to using pharmacological agents for CRF as evidence points the use of psychostimulants only in patients with moderate to severe fatigue with advanced cancer or those receiving active cancer therapy, with no evidence in their use in cancer patients who have completed active cancer therapy. Further research is needed.
癌症相关疲劳（CRF）是癌症患者中最常见且使人虚弱的症状。目前，有效治疗CRF的药物干预非常有限。在本文中，作者回顾了针对CRF的各种药物干预措施，并提出了进一步研究的未来方向。哌醋甲酯是治疗CRF研究最多的药物。各种药理研究表明皮质类固醇有益，特别是在晚期患者中短期使用。然而，最近的系统评价、荟萃分析和指南建议在使用治疗CRF的药物时要谨慎，因为证据表明精神兴奋剂仅适用于中度至重度疲劳的晚期癌症患者或接受积极癌症治疗的患者，尚无证据表明其可用于已完成积极癌症治疗的癌症患者。还需要进一步的研究。
