Predictors of response to corticosteroids for dyspnea in advanced cancer patients: a preliminary multicenter prospective observational study

Masanori Mori, Akemi Naito Shirado, Tatsuya Morita, Kenichiro Okamoto, Yoshinobu Matsuda, Yoshihisa Matsumoto, Hirohide Yamada, Hiroki Sakurai, Etsuko Aruga, Keisuke Kaneishi, Hiroaki Watanabe, Takashi Yamaguchi, Takuya Odagiri, Shuji Hiramoto, Hiroyuki Kohara, Naoki Matsuo, Hideki Katayama, Tomohiro Nishi, Takashi Matsui, Satoru Iwase

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Purpose: Although corticosteroids can relieve dyspnea in advanced cancer patients, factors predicting the response remain unknown. We aimed to explore potential factors predicting the response to corticosteroids for dyspnea in advanced cancer patients. Methods: In this preliminary multicenter prospective observational study, we included patients who had metastatic or locally advanced cancer, were receiving specialized palliative care services, and had a dyspnea intensity of ≥3 on a 0–10 Numerical Rating Scale (NRS) (worst during the last 24 h). The primary endpoint was NRS of dyspnea on day 3 after the administration of corticosteroids. Univariate/multivariate analyses were conducted to identify factors predicting ≥1-point reduction in NRS. Results: Of 74 patients who received corticosteroids, 50 (68%) showed ≥1-point reduction in dyspnea NRS. Factors that significantly predicted the response were an age of 70 years or older (82 vs. 53%, p = 0.008), absence of liver metastases (77 vs. 46%, p = 0.001), Palliative Prognostic Index (PPI) ≤ 6 (90 vs. 61%, p = 0.041), presence of pleuritis carcinomatosa with a small collection of pleural effusions (84 vs. 55%, p = 0.011), presence of audible wheezes (94 vs. 60%, p = 0.014), and baseline dyspnea NRS ≥7 (76% vs. 52%, p = 0.041). In a multivariate analysis, factors predicting response included PPI <6 (odds ratio (OR), 36.2; p = 0.021), baseline dyspnea NRS (worst) ≥7 (OR, 6.6; p = 0.036), and absence of liver metastases (OR, 0.19; p = 0.029) or ascites/liver enlargement (OR, 0.13; p = 0.050). Conclusions: The patient characteristics, etiologies of dyspnea, and clinical manifestations may predict responses to corticosteroids for dyspnea. Larger prospective studies are promising to confirm our findings.

Original languageEnglish
Pages (from-to)1169-1181
Number of pages13
JournalSupportive Care in Cancer
Issue number4
Publication statusPublished - Apr 1 2017
Externally publishedYes


  • Cancer
  • Corticosteroids
  • Dyspnea
  • Palliative care
  • Predictors

ASJC Scopus subject areas

  • Oncology


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