Effects of dexamethasone and placebo on symptom clusters in advanced cancer patients: A preliminary report

Sriram Yennurajalingam, Janet L. Williams, Gary Chisholm, Eduardo Bruera

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Objective. Advanced cancer patients frequently experience debilitating symptoms that occur in clusters, but few pharmacological studies have targeted symptom clusters. Our objective was to examine the effects of dexamethasone on symptom clusters in patients with advanced cancer. Methods.We reviewed the data from a previous randomized clinical trial to determine the effects of dexamethasone on cancersymptoms.Symptomclusterswereidentified according to baseline symptoms by using principal component analysis. Correlations and change in the severity of symptom clusters were analyzed after study treatment. Results. A total of 114 participants were included in this study. Three clusters were identified: fatigue/anorexia-cachexia/ depression (FAD), sleep/anxiety/drowsiness (SAD), and pain/dyspnea (PD). Changes in severity of FAD and PD significantly correlated over time (at baseline, day 8, and day 15). The FAD cluster was associated with significant improvement in severity at day 8 and day 15, whereas no significant change was observed with the SAD cluster or PD cluster after dexamethasone treatment. Conclusion. The results of this preliminary study suggest significant correlation over time and improvement in the FAD cluster at day 8 and day 15 after treatment with dexamethasone. These findings suggest that fatigue, anorexia-cachexia, and depression may share a common pathophysiologic basis. Further studies are needed to investigate this cluster and target anti-inflammatory therapies.

Original languageEnglish (US)
Pages (from-to)384-390
Number of pages7
JournalOncologist
Volume21
Issue number3
DOIs
StatePublished - Feb 17 2016

Keywords

  • Cytokines
  • Dexamethasone
  • Interventions
  • Principal component analysis
  • Symptom clusters

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

MD Anderson CCSG core facilities

  • Clinical and Translational Research Center

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