Effectiveness of Corticosteroid Monotherapy for Dyspnea Relief in Patients with Terminal Cancer
Effectiveness of Corticosteroid Monotherapy for Dyspnea Relief in Patients with Terminal Cancer
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DOI：
10.1080/15360288.2017.1301618
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发表时间：
2017-01-01
影响因子：
1.1
通讯作者：
Hayakawa, Toru
中科院分区：
文献类型：
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作者：
Maeda, Tsuyoshi;Hayakawa, Toru
呼吸困难是癌症患者的常见症状，尤其是晚期癌症患者。它明显影响晚期癌症患者，降低他们的生活质量。生活质量下降也影响生存率;因此，呼吸困难是一个预后因素。然而，皮质类固醇的作用，这往往是用来缓解呼吸困难，还没有得到充分的验证。在这项研究中，我们回顾性研究了皮质类固醇单药治疗是否对缓解呼吸困难有效。9名男性和2名女性研究受试者（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%。在第一天皮质类固醇剂量（25.5 +/- 10.86 vs. 36.1 +/- 16.39 mg，P = 0.29）或第2天给药剂量（47.7 +/- 25.99 vs. 72.2 +/- 32.78 mg，P = 0.25）方面，未发现应答者和无应答者之间存在显著差异。平均+/-标准误评估评分从皮质类固醇给药开始时的2.7 +/- 0.14显著变化至最大效应时的1.5 +/- 0.37（P =.028）;然而，最终给药时降至2.1 +/- 0.25并不显著（P =.068）。这表明皮质类固醇治疗缓解了呼吸困难，并可提供早期治疗选择。
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.