Factors Indicating Cancer-Related Neuropathic Pain Relief by Corticosteroids Administration

CONTEXT: Corticosteroids are frequently used for cancer-related neuropathic pain. However, the evidence for their efficacy is limited. OBJECTIVES: The purpose of this study was to identify factors that may indicate the efficacy of corticosteroids for cancer-related neuropathic pain. METHODS: This study was prospective multicenter observational and non-randomized cohort study with no placebo arm. Participants were recruited from 17 palliative care departments in Japan. All participants were thought to have cancer-related neuropathic pain and reported pain scores before and 7 days after corticosteroid administration. The primary outcome was the worst pain score in the last 24 hours. The secondary outcomes were Personalized Pain Goal and Patient Global Impression of Change. The multivariate logistic regression model was used to identify factors for cancer-related neuropathic pain by corticosteroid administration. RESULTS: A total of 97 participants were included in this study. Among the 97 participants, 50 achieved pain relief and 47 reported no pain relief. The multiple logistic regression model showed that normal white blood cell count (≤8500/µL) (P = .0049), low Karnofsky Performance Scale score (≤40) (P = .0080), and intracranial tumor as the origin of pain (P = .082) were factors related to relief of cancer-related neuropathic pain by corticosteroid administration. CONCLUSION: This study identified intracranial tumor, low Karnofsky Performance Scale, and normal WBC count as factors that may predict effectiveness of cancer-related neuropathic pain by corticosteroid administration.