Patient-Controlled Methylphenidate for the Management of Fatigue in Patients With Advanced Cancer: A Preliminary Report

Bruera, Éduardo; Driver, Larry C.; Barnes, Elizabeth; Willey, Jie; Shen, Lan; Palmer, J. Lynn; Escalante, Carmelita P

doi:10.1200/jco.2003.06.156

Cited by 190 publications

(104 citation statements)

References 15 publications

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“…Our study also showed preliminary evidence of improvement in CRF levels and trends toward improvement in other common cancer-related symptoms such as drowsiness and sleep disturbances (as assessed via the ESAS) most likely because of its psychostimulant effects similar to those of methylphenidate at 2 and 4 weeks of treatment. 61 However, randomized, placebocontrolled studies are needed to confirm these findings.…”

Section: Discussionmentioning

confidence: 99%

High-Dose Asian Ginseng (Panax Ginseng) for Cancer-Related Fatigue

et al. 2015

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Introduction and Objective. Cancer-related fatigue (CRF) is the most common and severe symptom in patients with cancer. The number and efficacy of available treatments for CRF are limited. The objective of this preliminary study was to assess the safety of high-dose Panax ginseng (PG) for CRF. Methods. In this prospective, open-label study, 30 patients with CRF (≥4/10) received high-dose PG at 800 mg orally daily for 29 days. Frequency and type of side effects were determined by the National Cancer Institute’s Common Terminology Criteria for Adverse Events, version 4.0. Scores on the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) scale, Edmonton Symptom Assessment System (ESAS), and Hospital Anxiety and Depression Scale (HADS) were assessed at baseline, day 15, and day 29. Global Symptom Evaluation (GSE) was assessed at day 29. Results. Of the 30 patients enrolled, 24 (80%) were evaluable. The median age was 58 years; 50% were females, and 84% were white. No severe (≥grade 3) adverse events related to the study drug were reported. Of the 24 evaluable patients, 21 (87%) had an improved (by ≥3 points) FACIT-F score by day 15. The mean ESAS score (standard deviation) for well-being improved from 4.67 (2.04) to 3.50 (2.34) ( P = .01374), and mean score for appetite improved from 4.29 (2.79) to 2.96 (2.46) ( P = .0097). GSE score of PG for fatigue was ≥3 in 15/24 patients (63%) with median improvement of 5. Conclusion. PG is safe and improves CRF fatigue as well as overall quality of life, appetite, and sleep at night. Randomized controlled trials of PG for CRF are justified.

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Section: Discussionmentioning

confidence: 99%

High-Dose Asian Ginseng (Panax Ginseng) for Cancer-Related Fatigue

et al. 2015

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“…The inclusion of a control group proved to be essential. Bruera and colleages had a comparable experience when testing methylphenidate for cancer fatigue [62,63]; although in their initial pilot study the scores on a fatigue scale improved significantly (by 17 points), the overall effects were markedly lower in their RCT (7.5 points for placebo and 9.6 points for methylphenidate). They stated that this lower improvement was probably the result of the double-blind controlled nature of their study and concluded that their findings reinforce the importance of conducting placebo-controlled trials to assess symptomatic outcomes.…”

Section: Expert Commentarymentioning

confidence: 99%

Interventions for cognitive deficits in patients with a brain tumor: an update

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et al. 2010

Expert Review of Anticancer Therapy

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“…Ondansetron, currently approved to prevent nausea and vomiting, was shown to improve symptoms of severe fatigue in some patients with chronic liver disease, 65 and methylphenidate has shown promise in improving symptoms of fatigue in some cancer patients, although the data are not conclusive. [66][67][68] Exercise programs have helped patients with other chronic diseases improve overall health and increase energy levels and therefore have the potential to ameliorate fatigue in patients with CHC. 69 Finally, social support and patient groups are another resource for patients with CHC who are coping with disease-related effects such as fatigue.…”

Section: Side Effects Of Chc Treatment and Their Managementmentioning

confidence: 99%