Kanbayashi Yuko, Hosokawa Toyoshi
Department of Hospital Pharmacy, University Hospital, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Pain Treatment and Palliative Care Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Clin Drug Investig. 2017 Apr;37(4):387-392. doi: 10.1007/s40261-017-0493-4.
Although some studies have examined the use of corticosteroids, their effectiveness in treating cancer-related fatigue (CRF) has yet to be established. Therefore, this retrospective study attempted to identify factors that would predict the usefulness of corticosteroids in treating CRF.
We examined 87 hospitalized end-of-life cancer patients who were given betamethasone for relief of CRF at our hospital between January 2008 and January 2014. We evaluated the effect of betamethasone at 3 days after administration and performed a multivariate logistic regression analysis designed to identify predictive factors for the usefulness of corticosteroids. Threshold measurements were examined using a receiver operating characteristic (ROC) curve.
This analysis identified the initial daily dose of betamethasone [odds ratio (OR) = 1.662], days from the start date of betamethasone administration to the date of death (OR = 1.05), administration of fentanyl (OR = 0.206) and age (OR = 1.055) as significant factors related to the effect of betamethasone. ROC curve analysis of the effect of the betamethasone showed that the threshold for the initial daily dose of betamethasone was above 4 mg, the threshold for the days from the start date of the betamethasone administration to the date of death was above 16 days and the threshold for age was above 60 years old.
The initial daily dose of betamethasone, days from the start date of the betamethasone administration to the date of death, non-administration of fentanyl and advanced age were shown to be predictive factors for the usefulness of corticosteroids for CRF in end-of-life patients.
尽管一些研究已对皮质类固醇的使用进行了考察，但其在治疗癌症相关疲劳（CRF）方面的有效性尚未确立。因此，这项回顾性研究试图确定可预测皮质类固醇治疗CRF有效性的因素。
我们考察了2008年1月至2014年1月期间在我院接受倍他米松治疗以缓解CRF的87例住院临终癌症患者。我们在给药3天后评估倍他米松的效果，并进行多因素逻辑回归分析以确定皮质类固醇有效性的预测因素。使用受试者工作特征（ROC）曲线检查阈值测量。
该分析确定倍他米松的初始日剂量[比值比（OR）=1.662]、从倍他米松给药开始日期到死亡日期的天数（OR=1.05）、芬太尼的使用（OR=0.206）和年龄（OR=1.055）是与倍他米松效果相关的显著因素。倍他米松效果的ROC曲线分析表明，倍他米松初始日剂量的阈值高于4mg，从倍他米松给药开始日期到死亡日期的天数阈值高于16天，年龄阈值高于60岁。
倍他米松的初始日剂量、从倍他米松给药开始日期到死亡日期的天数、未使用芬太尼和高龄被证明是皮质类固醇对临终患者CRF有效性的预测因素。
