Kim Kristine N, LaRiviere Michael, Macduffie Emily, White Caitlin A, Jordan-Luft Mary M, Anderson Eleanor, Ziegler Matthew, Radcliff Jacob A, Jones Joshua
Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Pract Radiat Oncol. 2023 Jan-Feb;13(1):28-40. doi: 10.1016/j.prro.2022.07.003. Epub 2022 Jul 30.
Glucocorticoids are commonly used in patients with cancer for symptom relief or as part of their anticancer treatment. Despite their frequent use, indications and dosing regimens are not exclusively evidence-based and can come with a multitude of adverse effects, some of which can be life-threatening. The objective of this review is to update our current state of knowledge on the use of glucocorticoids in adult patients with cancer.
A comprehensive literature review (1949-2022) was conducted using search terms "glucocorticoids," "corticosteroids," and "cancer." Information was organized by main concepts including indications, potential benefits, and prevention and management of common side effects of glucocorticoid therapy, in addition to appropriate dosing and taper regimens.
Glucocorticoids can be highly effective in improving outcomes and quality of life in patients with cancer. Their uses include management of disease manifestations, symptoms, and complications of cancer treatment. The lowest effective dose should be used and treatment duration should be minimized as clinically feasible. Side effects can be minimized by careful monitoring, continued assessment of benefits versus harms, and preventative measures for expected side effects.
This review provides general principles and practical recommendations on the use of glucocorticoids in patients with cancer. Further prospective studies on the outcomes of patients on glucocorticoids may help guide practice.
糖皮质激素常用于癌症患者以缓解症状或作为其抗癌治疗的一部分。尽管其使用频繁，但适应证和给药方案并非完全基于证据，且可能伴有多种不良反应，其中一些可能危及生命。本综述的目的是更新我们目前关于成年癌症患者使用糖皮质激素的知识状态。
使用搜索词“糖皮质激素”“皮质类固醇”和“癌症”进行了全面的文献综述（1949 - 2022年）。除了适当的给药和减量方案外，信息还按照主要概念进行了组织，包括糖皮质激素治疗的适应证、潜在益处以及常见副作用的预防和管理。
糖皮质激素在改善癌症患者的预后和生活质量方面可能非常有效。其用途包括管理癌症的疾病表现、症状和治疗并发症。应使用最低有效剂量，并在临床可行的情况下尽量缩短治疗持续时间。通过仔细监测、持续评估利弊以及针对预期副作用采取预防措施，可以将副作用降至最低。
本综述提供了关于癌症患者使用糖皮质激素的一般原则和实用建议。进一步对使用糖皮质激素患者的预后进行前瞻性研究可能有助于指导实践。
