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Literature DB >> 26888692

Effects of Dexamethasone and Placebo on Symptom Clusters in Advanced Cancer Patients: A Preliminary Report.

Sriram Yennurajalingam¹, Janet L Williams², Gary Chisholm³, Eduardo Bruera².

Abstract

OBJECTIVE: Advanced cancer patients frequently experience debilitating symptoms that occur in clusters, but few pharmacological studies have targeted symptom clusters. Our objective was to examine the effects of dexamethasone on symptom clusters in patients with advanced cancer.
METHODS: We reviewed the data from a previous randomized clinical trial to determine the effects of dexamethasone on cancer symptoms. Symptom clusters were identified according to baseline symptoms by using principal component analysis. Correlations and change in the severity of symptom clusters were analyzed after study treatment.
RESULTS: A total of 114 participants were included in this study. Three clusters were identified: fatigue/anorexia-cachexia/depression (FAD), sleep/anxiety/drowsiness (SAD), and pain/dyspnea (PD). Changes in severity of FAD and PD significantly correlated over time (at baseline, day 8, and day 15). The FAD cluster was associated with significant improvement in severity at day 8 and day 15, whereas no significant change was observed with the SAD cluster or PD cluster after dexamethasone treatment.
CONCLUSION: The results of this preliminary study suggest significant correlation over time and improvement in the FAD cluster at day 8 and day 15 after treatment with dexamethasone. These findings suggest that fatigue, anorexia-cachexia, and depression may share a common pathophysiologic basis. Further studies are needed to investigate this cluster and target anti-inflammatory therapies. ©AlphaMed Press.

Entities: Chemical Disease Species

Keywords: Cytokines; Dexamethasone; Interventions; Principal component analysis; Symptom clusters

Mesh：

Substances：
Placebos
Dexamethasone

Year: 2016 PMID： 26888692 PMCID： PMC4786346 DOI： 10.1634/theoncologist.2014-0260

Source DB: PubMed Journal: Oncologist ISSN： 1083-7159

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Authors: Jawed A Siddiqui; Ramesh Pothuraju; Maneesh Jain; Surinder K Batra; Mohd W Nasser
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Effects of Dexamethasone and Placebo on Symptom Clusters in Advanced Cancer Patients: A Preliminary Report.

1. Corticosteroid therapy of preterminal gastrointestinal cancer.

2. Prednisolone as an appetite stimulant in patients with cancer.

3. Impact of a palliative care consultation team on cancer-related symptoms in advanced cancer patients referred to an outpatient supportive care clinic.

4. Symptom clusters and their effect on the functional status of patients with cancer.

5. Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases.

6. Symptoms and prognosis in advanced cancer.

Review 7. Recent findings on how proinflammatory cytokines cause pain: peripheral mechanisms in inflammatory and neuropathic hyperalgesia.

8. Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales.

9. Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism? A cytokine-immunologic model of cancer symptoms.

10. Action of oral methylprednisolone in terminal cancer patients: a prospective randomized double-blind study.

Review 1. Advances in cancer cachexia: Intersection between affected organs, mediators, and pharmacological interventions.

2. Sleep disturbances in advanced cancer patients admitted to a supportive/palliative care unit.

3. Systemic corticosteroids for the management of cancer-related breathlessness (dyspnoea) in adults.

4. The relationship between pro-inflammatory cytokines and pain, appetite and fatigue in patients with advanced cancer.

5. Opioid Use in Patients With Cervical Cancer at Two Urban Medical Centers.

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Review 7. [Research Progress of Pharmacological Therapy and Nutritional Support for Cachexia  in Lung Cancer Patients].

Review 8. Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer.

Review 7. Recent findings on how proinflammatory cytokines cause pain: peripheral mechanisms in inflammatory and neuropathic hyperalgesia.

Review 1. Advances in cancer cachexia: Intersection between affected organs, mediators, and pharmacological interventions.

Review 6. Practice review: Evidence-based and effective management of fatigue in patients with advanced cancer.

Review 7. [Research Progress of Pharmacological Therapy and Nutritional Support for Cachexia in Lung Cancer Patients].

Review 8. Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer.

Review 7. [Research Progress of Pharmacological Therapy and Nutritional Support for Cachexia  in Lung Cancer Patients].