Abstract
Corticosteroids are frequently used to treat cancer-related fatigue (CRF), but it is yet to be established as standard care, and few reports have defined the appropriate time to start treatment. We investigated the optimal time for starting betamethasone and evaluated the clinical validity of using the prognostic nutritional index (PNI) for this purpose. Data were retrospectively collected for patients with terminal cancer receiving betamethasone for palliative care. Fatigue strength was evaluated by the daily occurrence of fatigue, using proportion of adequate fatigue, AF(%), defined as the average of the daily score for all treatment days, AF(%)all, the initial 5 days, AF(%)initi5, or the last 5 days, AF(%)last5. We examined (1) the relationship between survival time and adequate fatigue for CRF and (2) the correlation between survival time and PNI (based on serum albumin and lymphocytes). Data from 24 patients were included. The AF(%)allwas approximately 50% at 42 days before death and gradually decreased as the survival time shortened ( R2=.41, P <.001). There was a clear positive correlation between AF(%)alland AF(%)initi5( R2=.84, P <.001). At 42 days before death, PNI was approximately 30 and significantly correlated wit...Continue Reading
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