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RESEARCH PRODUCT

A Prospective Randomized Study of Corticosteroids as Adjuvant Drugs to Opioids in Advanced Cancer Patients

Salvatore MangioneCasuccio AlessandraSebastiano MercadanteMichela BerchovichFabio Fulfaro

subject

AdultMalecorticosteroidmedicine.medical_treatmentAnti-Inflammatory Agentslaw.invention03 medical and health sciences0302 clinical medicinePharmacotherapyRandomized controlled trial030502 gerontologylawNeoplasmsmedicineHumansProspective Studiesopioids in advanced cancer patientsprospective randomized studyProspective cohort studyDexamethasoneAgedPain MeasurementAged 80 and overAnalysis of VarianceChemotherapyadjuvant drugDose-Response Relationship Drugbusiness.industryPalliative CareGeneral MedicineMiddle AgedPain IntractableAnalgesics OpioidTreatment OutcomeOpioidChemotherapy Adjuvant030220 oncology & carcinogenesisAnesthesiaDrug Therapy CombinationFemale0305 other medical scienceCancer painbusinessAdjuvantFollow-Up Studiesmedicine.drug

description

This randomized controlled study evaluated the role of corticosteroids as adjuvants to opioid therapy in 76 advanced cancer patients with pain who requiring strong opioids. Patients were divided in 2 groups. Group O received conventional opioid treatment. Group OS received dexamethasone (8 mg orally) along with conventional treatment. Pain and symptom intensity, sense of well-being, and opioid escalation index and distress score were recorded at weekly intervals until death. No differences in pain intensity, opioid consumption, and opioid escalation index were found in 66 patients who survived 33 to 37 days. Corticosteroids did not provide significant additional analgesia to opioids, but persistently decreased opioid-related gastrointestinal symptoms for the patients with limited survival and improved the sense of well-being for some weeks. Corticosteroidrelated toxicity was minimal. Further studies with an increased sample size are necessary to detect any minimal difference in analgesia between the two groups.

https://doi.org/10.1177/1049909106295431