期刊
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
卷 28, 期 4, 页码 381-388出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2004.01.009
关键词
chronic nausea; anorexia; dexamethasone; metoclopramide; palliative care; advanced cancer; clinical trial
Chronic nausea occurs in most patients with advanced cancer. This study was done to assess the antiemetic effects of dexamethasone in patients with chronic nausea refractory to metoclopramide. Secondary outcomes included appetite, fatigue, and, pain. Fifty-one patients who had nausea (greater than or equal to 3/10 on a 0-10 scale) for greater than or equal to 2 weeks despite 48 hours of oral metoclopramide therapy (40-60 mg/day) were enrolled. Patients received 20 mg/day dexamethasone (DM) orally (n = 25) or placebo (n = 26) for severe nausea in addition to metoclopramide (60 mg/day orally). At baseline the mean nausea intensity ratings in the DM and placebo groups were 8.0 and 7.4. At Day 8 them, were 2.1 and 2.0, respectively. At Day 3 and Day 8, the)mean difference in nausea intensity for the DM and placebo groups was 4.5 and 2.9 (P = 0.16) and 5.9 and 5.7 (P = 0.85), respectively. Improvement in appetite and fatigue were observed on Day 3 and Day 8 in both groups as compared with the baseline. Pain, vomiting, well-being, and quality of life remained unchanged in both groups at both times. We conclude that DM was not superior to placebo in the management of chronic nausea in our patients with advanced cancer. (C) 2004 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
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