Predictors of responses to corticosteroids for anorexia in advanced cancer patients: a multicenter prospective observational study

Naoki Matsuo, Tatsuya Morita, Yoshinobu Matsuda, Kenichiro Okamoto, Yoshihisa Matsumoto, Keisuke Kaneishi, Takuya Odagiri, Hiroki Sakurai, Hideki Katayama, Ichiro Mori, Hirohide Yamada, Hiroaki Watanabe, Taro Yokoyama, Takashi Yamaguchi, Tomohiro Nishi, Akemi Shirado, Shuji Hiramoto, Toshio Watanabe, Hiroyuki Kohara, Satofumi ShimoyamaEtsuko Aruga, Mika Baba, Koki Sumita, Satoru Iwase

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Although corticosteroids are widely used to relieve anorexia, information regarding the factors predicting responses to corticosteroids remains limited. The purpose of the study is to identify potential factors predicting responses to corticosteroids for anorexia in advanced cancer patients. Methods: Inclusion criteria for this multicenter prospective observational study were patients who had metastatic or locally advanced cancer and had an anorexia intensity score of 4 or more on a 0–10 Numerical Rating Scale (NRS). Univariate and multivariate analyses were conducted to identify the factors predicting ≥2-point reduction in NRS on day 3. Results: Among 180 patients who received corticosteroids, 99 (55 %; 95 % confidence interval [CI], 47–62 %) had a response with ≥2-point reduction. Factors that significantly predicted responses were Palliative Performance Scale (PPS) > 40 and absence of drowsiness. In addition, factors that tended to be associated with ≥2-point reduction in NRS included PS 0–3, absence of diabetes mellitus, absence of peripheral edema, presence of lung metastasis, absence of peritoneal metastasis, baseline anorexia NRS of >6, presence of pain, and presence of constipation. A multivariate analysis showed that the independent factors predicting responses were PPS of >40 (odds ratio = 2.7 [95 % CI = 1.4–5.2]), absence of drowsiness (2.6 [1.3–5.0]), and baseline NRS of >6 (2.4 [1.1–4.8]). Conclusions: Treatment responses to corticosteroids for anorexia may be predicted by PPS, drowsiness, and baseline symptom intensity. Larger prospective studies are needed to confirm these results.

Original languageEnglish
Pages (from-to)41-50
Number of pages10
JournalSupportive Care in Cancer
Volume25
Issue number1
DOIs
Publication statusPublished - Jan 1 2017
Externally publishedYes

Keywords

  • Anorexia
  • Cancer
  • Corticosteroids
  • Palliative care
  • Predictors

ASJC Scopus subject areas

  • Oncology

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