Show simple item record

dc.contributor.authorHaywood, Alison
dc.contributor.authorGood, Phillip
dc.contributor.authorKhan, Sohil
dc.contributor.authorLeupp, Aurelia
dc.contributor.authorJenkins-Marsh, Sue
dc.contributor.authorRickett, Kirsty
dc.contributor.authorHardy, Janet R
dc.contributor.editorThe Cochrane Collaboration
dc.date.accessioned2017-10-03T12:30:37Z
dc.date.available2017-10-03T12:30:37Z
dc.date.issued2015
dc.identifier.issn1469-493X
dc.identifier.doi10.1002/14651858.CD010756.pub2
dc.identifier.urihttp://hdl.handle.net/10072/134448
dc.description.abstractBackground: One of the most feared symptoms associated with cancer is pain. Opioids remain the mainstay of pain treatment but corticosteroids are often used concurrently as co- or adjuvant analgesics. Due to their anti-inflammatory mechanism of action, corticosteroids are said to provide effective analgesia for pain associated with inflammation and in the management of cancer-related complications such as brain metastasis and spinal cord compression. However, corticosteroids have a wide range of adverse effects that are dose and time dependent. Objectives: To evaluate the efficacy of corticosteroids in treating cancer-related pain in adults. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2014, Issue 4), MEDLINE (OVID) (1966 to 29 September 2014), EMBASE (OVID) (1970 to 29 September 2014), CINAHL (1982 to 29 September 2014), Science Citation Index (Web of Science) (1899 to 29 September 2014) and Conference Proceedings Citation Index - Science (Web of Science) (1990 to 29 September 2014). Selection criteria: Any randomised or prospective controlled trial that included patients over 18 years with cancer-related pain were eligible for the review. Corticosteroids were compared to placebo or usual treatment and/or supportive care. Data collection and analysis: All review authors independently assessed trial quality and extracted data. We used arithmetic means and standard deviations for each outcome to report the mean difference (MD) with 95% confidence interval (CI). Main results: Fifteen studies met the inclusion criteria, enrolling 1926 participants. The trial size varied from 20 to 598 patients. Most studies compared corticosteroids, particularly dexamethasone, to standard therapy. We included six studies with data at one week in the meta-analysis for pain intensity; no data were available at that time point for the remaining studies. Corticosteroid therapy resulted in less pain (measured on a scale of 0 to 10 with a lower score indicating less pain) compared to control at one week (MD 0.84 lower pain, 95% CI 1.38 to 0.30 lower; low quality evidence). Adverse events were poorly documented. Factors limiting statistical analysis included the lack of standardised measurements of pain and the use of different agents, dosages, comparisons and routes of drug delivery. Subgroup analysis according to type of cancer was not possible. The quality of this evidence was limited by the risk of bias of the studies and small sample size. The results were also compromised by attrition, with data missing for the enrolled patients. Authors' conclusions: The evidence for the efficacy of corticosteroids for pain control in cancer patients is weak. Significant pain relief was noted in some studies, albeit only for a short period of time. This could be important for patients with poor clinical status. Further trials, with increased numbers of participants, are needed to evaluate the safety and effectiveness of corticosteroids for the management cancer pain in adults, and to establish an ideal dose, duration of therapy and route of administration.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherJohn Wiley & Sons
dc.publisher.placeUnited Kingdom
dc.relation.ispartofpagefromCD010756-1
dc.relation.ispartofpagetoCD010756-44
dc.relation.ispartofjournalCochrane Database of Systematic Reviews
dc.relation.ispartofvolume4
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchClinical pharmacology and therapeutics
dc.subject.fieldofresearchPsychology
dc.subject.fieldofresearchHealth sciences
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode321402
dc.subject.fieldofresearchcode52
dc.subject.fieldofresearchcode42
dc.titleCorticosteroids for the management of cancer-related pain in adults (Review)
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dc.description.versionVersion of Record (VoR)
gro.facultyGriffith Health, School of Pharmacy
gro.rights.copyright© 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2015, Issue 4. Art. No.: CD010756. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.
gro.hasfulltextFull Text
gro.griffith.authorHaywood, Alison
gro.griffith.authorKhan, Sohil A.


Files in this item

This item appears in the following Collection(s)

  • Journal articles
    Contains articles published by Griffith authors in scholarly journals.

Show simple item record