• Naoki Matsuo, Tatsuya Morita, Yoshinobu Matsuda, Kenichiro Okamoto, Yoshihisa Matsumoto, Keisuke Kaneishi, Takuya Odagiri, Hiroki Sakurai, Hideki Katayama, Ichiro Mori, Hirohide Yamada, Hiroaki Watanabe, Taro Yokoyama, Takashi Yamaguchi, Tomohiro Nishi, Akemi Shirado, Shuji Hiramoto, Toshio Watanabe, Hiroyuki Kohara, Satofumi Shimoyama, Etsuko Aruga, Mika Baba, Koki Sumita, and Satoru Iwase.
• Hospice, Medical Corporation Junkei-kai Sotoasahikawa Hospital, Sotoasahikawa, Akita, Akita, Japan. Electronic address: matsuo@jkk-sotohp.or.jp.
• J Pain Symptom Manage. 2016 Jul 1; 52 (1): 64-72.

ContextAlthough corticosteroids are widely used to relieve cancer-related fatigue (CRF), information regarding the factors predicting responses to corticosteroids remains limited.ObjectivesThe aim of this study was to identify potential factors predicting responses to corticosteroids for CRF in advanced cancer patients.MethodsInclusion criteria for this multicenter, prospective, observational study were patients who had metastatic or locally advanced cancer and had a fatigue intensity score of 4 or more on a 0-10 Numerical Rating Scale (NRS). Univariate and multivariate analyses were conducted to identify the factors predicting two-point reduction or more in NRS on day 3.ResultsAmong 179 patients who received corticosteroids, 86 (48%; 95% CI 41%-56%) had a response with two-point reduction or more. Factors that significantly predicted responses were performance status score of 3 or more, Palliative Performance Scale score more than 40, absence of ascites, absence of drowsiness, absence of depression, serum albumin level greater than 3 mg/dL, serum sodium level greater than 135 mEq/L, and baseline NRS score greater than 5. A multivariate analysis showed that the independent factors predicting responses were baseline NRS score greater than 5 (odds ratio [OR] 6.6, 95% CI 2.8-15.4), Palliative Performance Scale score more than 40 (OR 4.4, 95% CI 2.1-9.3), absence of drowsiness (OR 3.4, 95% CI 1.7-6.9), absence of ascites (OR 2.3, 95% CI 1.1-4.7), and absence of pleural effusion (OR 2.2, 95% CI 1.0-5.0).ConclusionTreatment responses to corticosteroids for CRF may be predicted by baseline symptom intensity, performance status, drowsiness, and severity of fluid retention symptoms. Larger prospective studies are needed to confirm these results.Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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