Maeda Tsuyoshi, Hayakawa Toru
J Pain Palliat Care Pharmacother. 2017 Jun;31(2):148-153. doi: 10.1080/15360288.2017.1301618. Epub 2017 Mar 30.
Dyspnea is a common symptom in patients with cancer, particularly those with late-stage terminal disease. It markedly affects terminal cancer patients, reducing their quality of life. Reduced quality of life also affects survival; therefore, dyspnea is a prognostic factor. However, the role of corticosteroids, which often are used to alleviate dyspnea, has not been sufficiently validated. In this study, we retrospectively investigated whether corticosteroid monotherapy was effective for dyspnea palliation. The effectiveness rate of corticosteroid therapy was 45% in nine male and two female study subjects (mean age: 74.5 years; range: 64-86 years). No significant differences were found between responders and nonresponders in the first-day corticosteroid doses (25.5 ± 10.86 vs. 36.1 ± 16.39 mg, P = .29) or doses administered on 2 days (47.7 ± 25.99 vs. 72.2 ± 32.78 mg, P = .25). The mean ± standard error assessment score changed significantly from 2.7 ± 0.14 at the beginning of corticosteroid administration to 1.5 ± 0.37 at the time of maximum effect (P = .028); however, the decrease to 2.1 ± 0.25 at the final administration was not significant (P = .068). This indicates that corticosteroid therapy relieved dyspnea and could provide an early-stage treatment option.
呼吸困难是癌症患者，尤其是晚期绝症患者的常见症状。它对晚期癌症患者有显著影响，降低他们的生活质量。生活质量下降也会影响生存；因此，呼吸困难是一个预后因素。然而，常用于缓解呼吸困难的皮质类固醇的作用尚未得到充分验证。在本研究中，我们回顾性调查了皮质类固醇单一疗法对缓解呼吸困难是否有效。在9名男性和2名女性研究对象（平均年龄：74.5岁；范围：64 - 86岁）中，皮质类固醇治疗的有效率为45%。在首日皮质类固醇剂量（25.5±10.86对36.1±16.39毫克，P = 0.29）或第2天给药剂量（47.7±25.99对72.2±32.78毫克，P = 0.25）方面，反应者和无反应者之间未发现显著差异。平均±标准误评估评分从开始给予皮质类固醇时的2.7±0.14显著变化至最大效应时的1.5±0.37（P = 0.028）；然而，在最后一次给药时降至2.1±0.25并不显著（P = 0.068）。这表明皮质类固醇疗法可缓解呼吸困难，并可提供一种早期治疗选择。
