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. 2021 Nov 17;2(1):316-323.
doi: 10.1089/pmr.2021.0053. eCollection 2021.

Dexamethasone 8 mg for Cancer-Related Fatigue in Inpatients with Advanced Cancer Undergoing Palliative Care: A Multicenter Phase II Trial

Tomofumi Miura  1 , Ayumi Okizaki  2 , Hideaki Hasuo  3 , Eriko Satomi  4 , Keita Tagami  5 , Kengo Imai  6 , Takashi Kojima  7 , Hironaga Satake  8 , Hiroto Ishiki  4 , Akira Inoue  5 , Takuhiro Yamaguchi  9
Affiliations

Dexamethasone 8 mg for Cancer-Related Fatigue in Inpatients with Advanced Cancer Undergoing Palliative Care: A Multicenter Phase II Trial

Tomofumi Miura et al. Palliat Med Rep. .

Abstract

Objective: No standard treatment for cancer-related fatigue (CRF) for inpatients in a palliative care setting exists. The aim of this study was to validate the previous study-derived efficacy of dexamethasone 8 mg for CRF among inpatients in a palliative care setting. Methods: Inpatients with moderate fatigue (≥4/10) were enrolled in a multicenter phase II trial. Dexamethasone 8 mg p.o. or 6.6 mg i.v. was administered for seven days and 4 mg p.o. or 3.3 mg i.v. for seven consecutive days. The primary endpoint was a threshold average change of Functional Assessment of Chronic Illness Therapy (FACIT)-fatigue subscale score of 3. The secondary endpoints were evaluated with the anorexia-cachexia subscale (ACS), and the Edmonton symptom assessment scale-revised Japanese version. Results: A total of 32 patients were enrolled. On day 8, the mean change of FACIT-fatigue subscale from day 1 was 5.2 (95% confidence interval 0.8-10.0), in which the lower bound was above 0 but not above the prespecified threshold value of 3.0 (p = 0.72). Edmonton symptom assessment system (ESAS)-fatigue was significantly improved by day 3 (p = 0.02), but not on day 8 or day 15. ACS, physical well-being, and ESAS-lack of appetite significantly improved by day 8 and day 15. Adverse events were tolerable. Conclusion: This study showed that dexamethasone 8 mg failed to achieve the preset efficacy for CRF among inpatients in a palliative care setting. However, this treatment improved fatigue and would be an option for CRF. jRCT (jRCTs031180068).

Keywords: appetite; cancer patients; cancer-related fatigue; dexamethasone; inpatient; palliative care.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
CONSORT diagram.
See this image and copyright information in PMC

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