Naoki Matsuo1, Tatsuya Morita2, Yoshinobu Matsuda3, Kenichiro Okamoto4, Yoshihisa Matsumoto5, Keisuke Kaneishi6, Takuya Odagiri7, Hiroki Sakurai8, Hideki Katayama9, Ichiro Mori10, Hirohide Yamada11, Hiroaki Watanabe12, Taro Yokoyama13, Takashi Yamaguchi14, Tomohiro Nishi15, Akemi Shirado16, Shuji Hiramoto17, Toshio Watanabe18, Hiroyuki Kohara19, Satofumi Shimoyama20, Etsuko Aruga21, Mika Baba22, Koki Sumita23, Satoru Iwase24. 1. Hospice, Medical Corporation Junkei-kai Sotoasahikawa Hospital, 42, Aza-Sangoden, Sotoasahikawa, Akita, Akita, 010-0802, Japan. matsuo@jkk-sotohp.or.jp. 2. Palliative and Supportive care Division, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu, Shizuoka, 433-8558, Japan. 3. Department of Psychosomatic Internal Medicine, National Hospital, Organization Kinki-Chuo Chest Medical Center, Sakai City, Osaka, 591-8555, Japan. 4. Palliative Medicine, Showa University Northern Yokohama Hospital, 35-1 Chigasaki Chuo Tsuduki-ku, Yokohama, Kanagawa, 224-8503, Japan. 5. Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. 6. Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center, 5-1 Tsukudo-cho, Shinjuku, Tokyo, 162-0815, Japan. 7. Komaki City Hospital, 1-20 Jobushi, Komaki-city, Aichi, 485-8520, Japan. 8. Department of Palliative Care and Pain Management, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. 9. NHO Yamaguchi-Ube Medical Center, 685, Higashi-Kiwa, Ube, Yamaguchi, 755-0241, Japan. 10. Gratia Hospital Hospice, 6-14-1 Aomadaninishi, Mino, Osaka, 562-8567, Japan. 11. Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan. 12. Komaki City Hospital, 1-20 Jobushi, Komaki, Aichi, 485-8520, Japan. 13. Department of Palliative Medicine, Yokohama Municipal Citizens Hospital, 56, Okazawa-cho, Hodogaya-ku, Yokohama, Kanagawa, 240-8555, Japan. 14. Department of Palliative Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunokicho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan. 15. Kawasaki Municipal Ida Hospital, Nakahara-ku Ida, Kawasaki, Kanagawa, 2-27-1, Japan. 16. Seirei Mikatahara General Hospital, 3453, Mikatahara-Cho, Kita-Ku, Hamamatsu, Shizuoka, 433-8558, Japan. 17. Department of Oncology, Mitsubishi Kyoto Hospital, Katsura Goshocho1, Nisikyo-ku, Kyoto, 615-8087, Japan. 18. Toyama Prefectural Central Hospital, 2-2-78, Nishinagae, Toyama, Toyama, 930-8550, Japan. 19. Department of Palliative Care, Hiroshima Prefectural Hospital, 1-5-54, Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan. 20. Department of Palliative Care, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan. 21. Department of Palliative Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. 22. Palliative Care Division, Saito Yukoukai Hospital, 7-2-18 Saito Asagi, Ibaragi, Osaka, 567-0085, Japan. 23. Matsue City Hospital, 32-1, Noshira-cho, Matsue, Shimane, 690-8509, Japan. 24. Research Hospital, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan.
Abstract
PURPOSE: Although corticosteroids are widely used to relieve anorexia, information regarding the factors predicting responses to corticosteroids remains limited. The purpose of the study is to identify potential factors predicting responses to corticosteroids for anorexia in advanced cancer patients. METHODS: Inclusion criteria for this multicenter prospective observational study were patients who had metastatic or locally advanced cancer and had an anorexia 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 ≥2-point reduction in NRS on day 3. RESULTS: Among 180 patients who received corticosteroids, 99 (55 %; 95 % confidence interval [CI], 47-62 %) had a response with ≥2-point reduction. Factors that significantly predicted responses were Palliative Performance Scale (PPS) > 40 and absence of drowsiness. In addition, factors that tended to be associated with ≥2-point reduction in NRS included PS 0-3, absence of diabetes mellitus, absence of peripheral edema, presence of lung metastasis, absence of peritoneal metastasis, baseline anorexia NRS of >6, presence of pain, and presence of constipation. A multivariate analysis showed that the independent factors predicting responses were PPS of >40 (odds ratio = 2.7 [95 % CI = 1.4-5.2]), absence of drowsiness (2.6 [1.3-5.0]), and baseline NRS of >6 (2.4 [1.1-4.8]). CONCLUSIONS: Treatment responses to corticosteroids for anorexia may be predicted by PPS, drowsiness, and baseline symptom intensity. Larger prospective studies are needed to confirm these results.
PURPOSE: Although corticosteroids are widely used to relieve anorexia, information regarding the factors predicting responses to corticosteroids remains limited. The purpose of the study is to identify potential factors predicting responses to corticosteroids for anorexia in advanced cancerpatients. METHODS: Inclusion criteria for this multicenter prospective observational study were patients who had metastatic or locally advanced cancer and had an anorexia 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 ≥2-point reduction in NRS on day 3. RESULTS: Among 180 patients who received corticosteroids, 99 (55 %; 95 % confidence interval [CI], 47-62 %) had a response with ≥2-point reduction. Factors that significantly predicted responses were Palliative Performance Scale (PPS) > 40 and absence of drowsiness. In addition, factors that tended to be associated with ≥2-point reduction in NRS included PS 0-3, absence of diabetes mellitus, absence of peripheral edema, presence of lung metastasis, absence of peritoneal metastasis, baseline anorexia NRS of >6, presence of pain, and presence of constipation. A multivariate analysis showed that the independent factors predicting responses were PPS of >40 (odds ratio = 2.7 [95 % CI = 1.4-5.2]), absence of drowsiness (2.6 [1.3-5.0]), and baseline NRS of >6 (2.4 [1.1-4.8]). CONCLUSIONS: Treatment responses to corticosteroids for anorexia may be predicted by PPS, drowsiness, and baseline symptom intensity. Larger prospective studies are needed to confirm these results.
Authors: David Hui; Omar Shamieh; Carlos Eduardo Paiva; Pedro Emilio Perez-Cruz; Jung Hye Kwon; Mary Ann Muckaden; Minjeong Park; Sriram Yennu; Jung Hun Kang; Eduardo Bruera Journal: Cancer Date: 2015-06-08 Impact factor: 6.860
Authors: Ornulf Paulsen; Pål Klepstad; Jan Henrik Rosland; Nina Aass; Eva Albert; Peter Fayers; Stein Kaasa Journal: J Clin Oncol Date: 2014-07-07 Impact factor: 44.544