Yennurajalingam, S., Frisbee-Hume, S., Palmer, J.L., Delgado-Guay, M.O., Bull, J., Phan, A.T., . . . Bruera, E. (2013). Reduction of cancer-related fatigue with dexamethasone: A double-blind, randomized, placebo-controlled trial in patients with advanced cancer. Journal of Clinical Oncology, 31, 3076–3082.
Compare the effect of dexamethasone and placebo on cancer-related fatigue (CRF) and quality of life.
Dexamethasone 4 mg or placebo orally twice a day for 14 days.
Dexamethasone and placebo groups had no differences in patient characteristics at baseline with the exception of more females in the dexamethasone group. Mean improvement scores of the FACIT-F subscale scores and ESAS physical distress scores were significantly better in the dexamethasone than the placebo group at days 8 (p = .005) and 15 (p = .008). ESAS pain was significantly better in the dexamethasone group on day 8. FAACT subscale scores were significantly better in the dexamethasone group on day 15. Fatigue did decline in both study groups. All other variables showed no significant differences in scores or frequency of adverse events.
Dexamethasone is more effective than placebo in improving CRF and quality of life in patients with advanced cancer.
A need exists for larger, long-term studies to determine safety and efficacy in patients with cancer (palliative care and active treatment). A significant number of patients with advanced cancer present with multiple signs and symptoms that may or may not benefit from dexamethasone therapy. Clinicians should be aware of barriers to adherence with dexamethasone.