Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Non-Steroid Anti-Inflammatory Agents for Management of Cold Sweating in Advanced Cancer Patients

식은 땀을 호소하는 진행성 암 환자에서 비스테로이드성 항염증 제제를 이용한 치료

  • Choi, Hye Jung (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Song, Haa-Na (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Kang, Jung Hun (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine)
  • 최혜정 (경상대학교병원 혈액종양내과) ;
  • 송하나 (경상대학교병원 혈액종양내과) ;
  • 강정훈 (경상대학교병원 혈액종양내과)
  • Received : 2016.05.22
  • Accepted : 2016.11.23
  • Published : 2016.12.01
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Abstract

Purpose: Advanced cancer may accompany cold sweat as paraneoplastic symptom. Few studies have been performed on the efficacy of non-steroid anti-inflammatory drug (NSAID) in advanced cancer patients who sweated without fever. Methods: To select study participants, medical records were retrospectively reviewed for patients who satisfied the following criteria: 1) incurable, advanced solid cancer; 2) Cold sweating of 4 or higher on the numeric rating scale (NRS) 4; 3) No evidence of infection or hypoglycemia; 4) No newly started opioid or anti-hormonal agents within one month; 5) NSAID prescription for the management of cold sweating and 6) Documented NRS information before and after NSAID administration. Results: A total of 13 patients were selected after excluding four patients due to lack of NRS information or fever. The mean age was 59 years old (range: 50~71), and nine patients (69%) were male. Bile duct cancer was the most common primary tumor followed by pancreatic cancer, gastric cancer and prostate cancer. The mean NRS of cold sweating dropped from baseline 6.5 (min-max: 4~10) to 1.9 at the follow-up assessment (min-max: 0~5). The mean follow-up period was 9.1 days (range: 2~30 days) from NSAID treatment to assessment. Conclusion: NSAID was effective medication for management of sweating without fever in patients with advanced cancer.

목적: 진행성 암 환자에서 발열이 동반되지 않은, 암성 발한에서 NSAID (non-steroid anti-inflammatory drug) 치료 효과를 알아보고자 함이 목적이다. 방법: 다음과 같은 조건을 만족하는 환자를 대상으로 후향적으로 의무 기록을 조사하였다. 1) 수술적 절제나 항암방사선 치료로 완치가 불가능한 진행성 암 환자 2) 숫자평가등급 4점 이상의 식은 땀을 호소하며 발열이 동반되지 않은 환자 3) 식은 땀의 원인이 될 만한 감염이 없고, 마약성 진통 및 호르몬 차단제를 현재 최근 1개월 이내 새롭게 사용하지 않는 환자 4) 식은 땀 치료를 위해 NSAID를 사용하고, NRS 평가가 치료 전 후 시행한 환자. 결과: 총 13명의 환자가 등록되었다. 남자가 9명(69%)이었고, 평균 59세(범위: 50~71)였다. 암종별 빈도는 담도암, 췌장암, 위암, 전립선암 순이었다. 치료 전 환자들의 식은 땀은 평균 NRS 6.5 (최소값: 4, 최대값: 10) 이었고, 치료 후에는 NRS 1.9 (최소값: 0, 최대값: 5)이었다. 평균 추적 관찰 기간은 9.1일이었다. 결론: 진행성 암 환자에서 열이 동반되지 않은 중등도 이상의 식은 땀 환자에서 NSAID는 효과적인 치료방법이다.

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References

  1. Quigley CS, Baines M. Descriptive epidemiology of sweating in a hospice population. J Palliat Care 1997;13:22-6.
  2. Zhukovsky DS. Fever and sweats in the patient with advanced cancer. Hematol Oncol Clin North Am 2002;16:579-88, viii. https://doi.org/10.1016/S0889-8588(02)00018-7
  3. Twycross R. Sweating in advanced cancer. Indian J Palliat Care 2004;10:1-11.
  4. Mullin J. A systematic review of the efficacy of the management of paraneoplastic sweating in palliative care populations. The SPPC Annual Conference; 2013 Oct 31; Edinburgh, Scotland. Edinburgh: Scottish Partnership for Palliative Care; 2014 /Poster.
  5. Cowap J, Hardy J. Thioridazine in the management of cancerrelated sweating. J Pain Symptom Manage 1998;15:266. https://doi.org/10.1016/S0885-3924(98)00013-X
  6. Porzio G, Aielli F, Verna L, Porto C, Aloisi P, Cannita K, et al. Gabapentin in the treatment of severe sweating experienced by advanced cancer patients. Support Care Cancer 2006;14:389-91. https://doi.org/10.1007/s00520-005-0014-5
  7. Deaner PB. The use of thalidomide in the management of severe sweating in patients with advanced malignancy: trial report. Palliat Med 2000;14:429-31. https://doi.org/10.1191/026921600701536110
  8. Zell JA, Chang JC. Neoplastic fever: a neglected paraneoplastic syndrome. Support Care Cancer 2005;13:870-7. https://doi.org/10.1007/s00520-005-0825-4
  9. Chang JC, Gross HM. Neoplastic fever responds to the treatment of an adequate dose of naproxen. J Clin Oncol 1985;3:552-8. https://doi.org/10.1200/JCO.1985.3.4.552
  10. Tsavaris N, Zinelis A, Karabelis A, Beldecos D, Bacojanis C, Milonacis N, et al. A randomized trial of the effect of three non-steroid anti-inflammatory agents in ameliorating cancer-induced fever. J Intern Med 1990;228:451-5. https://doi.org/10.1111/j.1365-2796.1990.tb00262.x
  11. Hanks G, Cherny NI, Christakis NA, Fallon M, Kaasa S, Portenoy RK. Oxford textbook of palliative medicine. 4th ed. Oxford:Oxford University Press;2011. p. 944-9.
  12. Calder K, Bruera E. Thalidomide for night sweats in patients with advanced cancer. Palliat Med 2000;14:77-8. https://doi.org/10.1177/026921630001400116
  13. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS):a simple method for the assessment of palliative care patients. J Palliat Care 1991;7:6-9.
  14. Lee GW, Oh SY, Kang MH, Kang JH, Park SH, Hwang IG, et al. Treatment of dexamethasone-induced hiccup in chemotherapy patients by methylprednisolone rotation. Oncologist;18:1229-34.