Corticosteroids in palliative cancer pain: a systematic review

Introduction: Pain is highly prevalent in palliative care (PC), particularly in advanced cancer, and is often inadequately controlled despite opioid therapy.Corticosteroids (CCT) are commonly used as adjuvant analgesics, although their efficacy remains uncertain.Objective: To evaluate the role of CCT in pain management in cancer patients receiving PC.Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted following PRISMA guidelines and registered in PROSPERO (CRD420261366663).Studies including adult patients receiving CCT for pain in PC were selected.A qualitative synthesis was performed.Results: Of 296 records identified, six studies were included.Dexamethasone (DXM) was the most frequently used CCT.Most studies suggested a potential reduction in pain intensity, particularly in cancer-related neuropathic pain and pain associated with bone metastases, with a possible rapid onset of action.However, evidence supporting opioid-sparing effects was inconsistent across studies.Conclusions: CCT may provide benefit as adjuvant analgesics in PC.However, the current evidence is limited and of low certainty, and further high-quality studies are required.