Predictors of the Usefulness of Corticosteroids for Cancer-Related Fatigue in End-of-Life Patients

Abstract

Although some studies have examined the use of corticosteroids, their effectiveness in treating cancer-related fatigue (CRF) has yet to be established. Therefore, this retrospective study attempted to identify factors that would predict the usefulness of corticosteroids in treating CRF. We examined 87 hospitalized end-of-life cancer patients who were given betamethasone for relief of CRF at our hospital between January 2008 and January 2014. We evaluated the effect of betamethasone at 3days after administration and performed a multivariate logistic regression analysis designed to identify predictive factors for the usefulness of corticosteroids. Threshold measurements were examined using a receiver operating characteristic (ROC) curve. This analysis identified the initial daily dose of betamethasone [odds ratio (OR)=1.662], days from the start date of betamethasone administration to the date of death (OR=1.05), administration of fentanyl (OR=0.206) and age (OR=1.055) as significant factors related to the effect of betamethasone. ROC curve analysis of the effect of the betamethasone showed that the threshold for the initial daily dose of betamethasone was above 4mg, the threshold for the days from the start date of the betamethasone administration to the date of death was above 16days and the threshold for age was above 60years old. The initial daily dose of betamethasone, days from the start date of the betamethasone administration to the date of death, non-administration of fentanyl and advanced age were shown to be predictive factors for the usefulness of corticosteroids for CRF in end-of-life patients.