Abstract：
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.
摘要：
在乳腺癌围手术期化疗中，地塞米松（DEX）以高剂量施用以防止不良反应。突然停止高剂量DEX治疗会导致疲劳，但是疲劳的发生率是不确定的。在这项研究中,我们回顾性评估了DEX支持治疗后疲劳的发生率，以及DEX逐渐减少对疲劳的改善，逐步减少每日剂量，乳腺癌患者。受试者为124例乳腺癌患者，接受以表柔比星或多西他赛为基础的方案作为围手术期化疗。在所有患者中，16.1%的患者在停止DEX给药后出现疲劳。6.5%的患者疲劳严重程度为1级,8.1%的患者为2级，1.6%的患者为3级。疲劳组与无疲劳组之间的DEX给药剂量和持续时间没有显着差异。几乎所有的疲劳患者,DEX从下一个循环开始逐渐变细。通过比较分级和主观症状来评估DEX逐渐减少的疗效。随着DEX的逐渐缩小，疲劳的严重程度显着降低（p<0.05），94.7%的患者主观症状得到改善。因此,乳腺癌患者停止DEX支持治疗后,偶尔会出现疲劳.DEX的逐渐变细可能对疲劳有效。
