Cochrane: One of the most feared symptoms associated with cancer is pain. Opioids
remain the mainstay of pain treatment but corticosteroids are often
used at the same time, along with standard pain relievers. This review evaluates the clinical trial evidence to
determine how effective corticosteroids are in treating cancer-related
pain in adults and how well tolerated this treatment is for these
patients. The evidence for the efficacy of corticosteroids for pain control
in cancer patients is weak.
We found 15 relevant studies with 1926 participants. The trial size varied from 20 to 598 patients and the duration of the included studies ranged from seven days to 42 weeks. Most studies compared corticosteroids, particularly dexamethasone, to standard therapy.
Overall, we found that the current evidence is based on studies that contain only a small number of patients. The following conclusions can be made from the available evidence: 1) the evidence for the efficacy of corticosteroids for pain control in cancer patients is weak (GRADE quality of evidence for pain outcome was low); 2) significant pain relief was noted in some studies, albeit only for a short period of time; this could be important for patients who have only a short time to live; 3) overall, more studies found corticosteroids not to be of benefit; 4) it was not possible to determine whether steroids are more effective for pain in specific cancers; and 5) the side effect profile of steroids, especially in the longer term, is not well described.
We found 15 relevant studies with 1926 participants. The trial size varied from 20 to 598 patients and the duration of the included studies ranged from seven days to 42 weeks. Most studies compared corticosteroids, particularly dexamethasone, to standard therapy.
Overall, we found that the current evidence is based on studies that contain only a small number of patients. The following conclusions can be made from the available evidence: 1) the evidence for the efficacy of corticosteroids for pain control in cancer patients is weak (GRADE quality of evidence for pain outcome was low); 2) significant pain relief was noted in some studies, albeit only for a short period of time; this could be important for patients who have only a short time to live; 3) overall, more studies found corticosteroids not to be of benefit; 4) it was not possible to determine whether steroids are more effective for pain in specific cancers; and 5) the side effect profile of steroids, especially in the longer term, is not well described.
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.