1. A Prospective Randomized Study of Corticosteroids as Adjuvant Drugs to Opioids in Advanced Cancer Patients
- Author
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Salvatore Mangione, Alessandra Casuccio, Sebastiano Mercadante, Michela Berchovich, Fabio Fulfaro, MERCADANTE, SL, BERCHOVICH, M, CASUCCIO, A, FULFARO, F, and MANGIONE, S
- Subjects
Adult ,Male ,corticosteroid ,medicine.medical_treatment ,Anti-Inflammatory Agents ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Randomized controlled trial ,030502 gerontology ,law ,Neoplasms ,medicine ,Humans ,Prospective Studies ,opioids in advanced cancer patients ,prospective randomized study ,Prospective cohort study ,Dexamethasone ,Aged ,Pain Measurement ,Aged, 80 and over ,Analysis of Variance ,Chemotherapy ,adjuvant drug ,Dose-Response Relationship, Drug ,business.industry ,Palliative Care ,General Medicine ,Middle Aged ,Pain, Intractable ,Analgesics, Opioid ,Treatment Outcome ,Opioid ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Anesthesia ,Drug Therapy, Combination ,Female ,0305 other medical science ,Cancer pain ,business ,Adjuvant ,Follow-Up Studies ,medicine.drug - Abstract
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.
- Published
- 2007
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