Incidence of Fatigue Following Dexamethasone Administration for Supportive Therapy and Efficacy of Tapering in Perioperative Chemotherapy for Breast Cancer: A Retrospective Observational Study

• Published in: Biological & pharmaceutical bulletin Vol. 47; no. 7; pp. 1326 - 1330
• Main Authors: Yabuta, Naoki, Noda, Satoshi, Sudo, Masatomo, Wakasugi, Yoshinori, Morii, Hiroaki, Tomida, Kaori, Morita, Shin-ya
• Format: Journal Article
• Language: English
• Published: Japan The Pharmaceutical Society of Japan 23.07.2024; Japan Science and Technology Agency
• Subjects: adrenal insufficiency; Adult; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - surgery; Cancer therapies; Chemotherapy; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Dexamethasone - therapeutic use; Docetaxel - administration & dosage; Docetaxel - adverse effects; Docetaxel - therapeutic use; Drug Tapering; Epirubicin; Epirubicin - administration & dosage; Epirubicin - adverse effects; Epirubicin - therapeutic use; Fatigue; Fatigue - drug therapy; Fatigue - etiology; Female; Humans; Incidence; Middle Aged; Observational studies; Perioperative Care - methods; Retrospective Studies; supportive therapy; tapering; dexamethasone; breast cancer; adrenal insufficiency; fatigue; tapering; supportive therapy
• ISSN: 0918-6158; 1347-5215; 1347-5215
• DOI: 10.1248/bpb.b24-00207

In perioperative chemotherapy for breast cancer, dexamethasone (DEX) is administered at high dose to prevent adverse effects. Abrupt cessation of high-dose DEX treatment induces fatigue, but the incidence of the fatigue is uncertain. In this study, we retrospectively evaluated the incidence of fatigue following DEX administration for supportive therapy and the improvement of fatigue with DEX tapering, a gradual reduction of the daily dose, in breast cancer patients. The subjects were 124 patients with breast cancer receiving epirubicin- or docetaxel-based regimens as perioperative chemotherapy. Of all patients, 16.1% of patients experienced fatigue after cessation of DEX administration. The severity of fatigue was grade 1 in 6.5% of patients, grade 2 in 8.1% of patients, and grade 3 in 1.6% of patients. There were no significant differences in dose and duration of DEX administration between the group with fatigue and the group without fatigue. In almost all patients with fatigue, DEX tapering was performed from the next cycle. The efficacy of DEX tapering was evaluated by comparing the grade and subjective symptoms. Following DEX tapering, the severity of fatigue was significantly reduced (p < 0.05), and the subjective symptom was improved in 94.7% of patients. Therefore, fatigue is occasionally induced after the cessation of DEX administration for supportive therapy in breast cancer patients. The tapering of DEX may be effective for fatigue.