Observational studySupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2020
How successful are we in relieving terminal dyspnea in cancer patients? A real-world multicenter prospective observational study.
Observational study in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 32 citations in OpenAlex.
- Longitudinal changes in delirium motor subtypes among patients with advanced cancer in inpatient hospice and palliative care units: A secondary analysis of a multicenter cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Observational
- Pharmacological Strategies for Providing Patients With Delirium Relief From Terminal Dyspnea: A Secondary Data Analysis.Cancer medicine · 2025Observational
- Palliative patients who may benefit from intranasal delivery of symptomatic drugs: a two-center observational study evaluated the administration of morphine and dexamethasone in Polish hospices.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Observational
- Current Management Options for Dyspnea in Cancer Patients.Current treatment options in oncology · 2023Review
- The feasibility and effects of a pharmacological treatment algorithm for cancer patients with terminal dyspnea: A multicenter cohort study.Cancer medicine · 2023Article
- Effectiveness and safety of opioids for dyspnea in patients with lung cancer: secondary analysis of multicenter prospective observational study.Translational lung cancer research · 2022Article
- COVID-19, Suffering and Palliative Care: A Review.The American journal of hospice & palliative care · 2022Review
- Factors Related to Family Caregivers' Readiness for the Hospital Discharge of Advanced Cancer Patients.International journal of environmental research and public health · 2022Article
- Prognostication of the Last Days of Life.Cancer research and treatment · 2022Article
- Experience of symptom control, anxiety and associating factors in a palliative care unit evaluated with Support Team Assessment Schedule Japanese version.Scientific reports · 2021Observational
- The Bereaved Families' Preferences for Individualized Goals of Care for Terminal Dyspnea: What Is an Acceptable Balance between Dyspnea Intensity and Communication Capacity?Palliative medicine reports · 2020Article
- Unanswered questions and future direction in the management of terminal breathlessness in patients with cancer.ESMO open · 2020Review
- Study Protocol for Feasibility Randomized, Placebo-Controlled Trial of Efficacy of Midazolam as the Second-Line Treatment for Dyspnea in Patients with Advanced Cancer.Palliative medicine reportsArticle
Corrections and comments
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Authors and funding
21 authors at 17 institutions in 1 country.
Funding
Abstract
purposeParenteral morphine is widely used for dyspnea of imminently dying cancer patients, but the outcomes to expect over time remain largely unknown. We examined outcomes after the administration of parenteral morphine infusion over 48 h in cancer patients with a poor performance status.
methodsThis was a multicenter prospective observational study. Inclusion criteria were metastatic/locally advanced cancer, ECOG performance status = 3-4, a dyspnea intensity ≥ 2 on a Support Team Assessment Schedule, Japanese version (STAS-J), and receiving specialized palliative care. After initiating parenteral morphine infusion, we measured dyspnea STAS-J as well as Memorial Delirium Assessment Scale (MDAS), item 9, and Communication Capacity Scale (CCS), item 4, every 6 h over 48 h.
resultsWe enrolled 167 patients (median survival = 4 days). The mean age was 70 years, 80 patients (48%) had lung cancer, and 109 (65%) had lung metastases. The mean STAS-J scores decreased from 3.1 (95% confidence interval (CI) = 3.0-3.2) at the baseline to 2.1 (95%CI = 1.9-2.2) at 6 h, and remained 1.6-1.8 over 12-48 h. The proportion of patients with dyspnea relief (STAS-J ≤ 1) increased to 39% at 6 h, and ranged between 49 and 61% over 12-48 h. In contrast, up to 6.6 and 20% of patients showed hyperactive delirium (MDAS item 9 ≥ 2) and an inability to communicate (CCS item 4 = 3), respectively, over 48 h.
conclusionsOverall, terminal dyspnea was relatively well controlled with parenteral morphine, though a significant number of patients continued to suffer from dyspnea. Future efforts are needed to improve outcomes following standardized dyspnea treatment using patient-reported outcomes for imminently dying patients.
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