Use of Dexamethasone for Severe Fatigue in the Advanced Cancer Population: A Brief Report.

Ingham, G; Urban, K; Phyo, Y; Hunt, J; Tuffin, P; Seah, D

Use of Dexamethasone for Severe Fatigue in the Advanced Cancer Population: A Brief Report.

Ingham, G Urban, K Phyo, Y

Hunt, J Tuffin, P Seah, D

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Publisher:: MARY ANN LIEBERT, INC
Publication Type:: Journal Article
Citation:: Palliat Med Rep, 2024, 5, (1), pp. 116-121
Issue Date:: 2024

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Field	Value	Language
dc.contributor.author	Ingham, G
dc.contributor.author	Urban, K
dc.contributor.author	Phyo, Y https://orcid.org/0000-0003-3029-409X
dc.contributor.author	Hunt, J
dc.contributor.author	Tuffin, P
dc.contributor.author	Seah, D
dc.date.accessioned	2024-08-06T03:19:33Z
dc.date.available	2024-01-02
dc.date.available	2024-08-06T03:19:33Z
dc.date.issued	2024
dc.identifier.citation	Palliat Med Rep, 2024, 5, (1), pp. 116-121
dc.identifier.issn	2689-2820
dc.identifier.issn	2689-2820
dc.identifier.uri	http://hdl.handle.net/10453/180105
dc.description.abstract	BACKGROUND: Fatigue is a common and distressing symptom for palliative care patients. Although the current literature emphasizes nonpharmacological management, dexamethasone is reportedly used in clinical practice. This study helps to characterize its use, efficacy, and adverse effects in a real-world setting. OBJECTIVE: To improve the evidence base by exploring the use, efficacy, and side effect profile of dexamethasone for fatigue management. METHODS: This international multisite prospective observational case series assessed the benefit and adverse effects of dexamethasone at baseline (T0) and at five to seven days postbaseline (T1). Fatigue scores were assessed using the symptom assessment scale (SAS) and visual analogue fatigue scale (VAFS). Adverse events were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE). The related samples Wilcoxon signed-rank test was used to compare before and after scores. RESULTS: All 18 patients (male-female, 11:7) had advanced metastatic cancer with most in the deteriorating palliative care phase (56%). The most common dose of dexamethasone was 4 mg daily orally. At T1 (n = 12), improvement was seen in all measures of fatigue; the median SAS scores decreased from 7 to 5.5 (p = 0.007), the median VAFS scores increased from 3 to 5 (p = 0.126), and the median NCI-CTCAE fatigue scores were reduced from 3 to 2.5 (p = 0.18). Dexamethasone was well tolerated; one participant experienced grade 3 delirium. CONCLUSION: The small number of participants recruited for this study suggests that dexamethasone is not widely used specifically for fatigue. Our results suggest an improvement in fatigue scores from T0 to T1.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	MARY ANN LIEBERT, INC
dc.relation.ispartof	Palliat Med Rep
dc.relation.isbasedon	10.1089/pmr.2023.0050
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	4203 Health services and systems
dc.title	Use of Dexamethasone for Severe Fatigue in the Advanced Cancer Population: A Brief Report.
dc.type	Journal Article
utslib.citation.volume	5
utslib.location.activity	United States
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2024-08-06T03:19:30Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	5
utslib.citation.issue	1

Abstract:

BACKGROUND: Fatigue is a common and distressing symptom for palliative care patients. Although the current literature emphasizes nonpharmacological management, dexamethasone is reportedly used in clinical practice. This study helps to characterize its use, efficacy, and adverse effects in a real-world setting. OBJECTIVE: To improve the evidence base by exploring the use, efficacy, and side effect profile of dexamethasone for fatigue management. METHODS: This international multisite prospective observational case series assessed the benefit and adverse effects of dexamethasone at baseline (T0) and at five to seven days postbaseline (T1). Fatigue scores were assessed using the symptom assessment scale (SAS) and visual analogue fatigue scale (VAFS). Adverse events were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE). The related samples Wilcoxon signed-rank test was used to compare before and after scores. RESULTS: All 18 patients (male-female, 11:7) had advanced metastatic cancer with most in the deteriorating palliative care phase (56%). The most common dose of dexamethasone was 4 mg daily orally. At T1 (n = 12), improvement was seen in all measures of fatigue; the median SAS scores decreased from 7 to 5.5 (p = 0.007), the median VAFS scores increased from 3 to 5 (p = 0.126), and the median NCI-CTCAE fatigue scores were reduced from 3 to 2.5 (p = 0.18). Dexamethasone was well tolerated; one participant experienced grade 3 delirium. CONCLUSION: The small number of participants recruited for this study suggests that dexamethasone is not widely used specifically for fatigue. Our results suggest an improvement in fatigue scores from T0 to T1.

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http://hdl.handle.net/10453/180105