High incidence of serious side effects of high-dose dexamethasone treatment in patients with epidural spinal cord compression
High incidence of serious side effects of high-dose dexamethasone treatment in patients with epidural spinal cord compression
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DOI：
10.1007/bf00172664
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发表时间：
1992-02
影响因子：
3.9
通讯作者：
K. Heimdal;H. Hirschberg;H. Slettebø;K. Watne;O. Nome
中科院分区：
文献类型：
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作者：
K. Heimdal;H. Hirschberg;H. Slettebø;K. Watne;O. Nome
连续 28 名患者因恶性疾病导致硬膜外脊髓受压，接受大剂量地塞米松（96 mg 静脉注射负荷剂量，14 天内剂量降至零）和放疗。有八个事件被归类为地塞米松治疗的副作用。其中 4 例被认为是严重的（1 例伴有出血的致命性溃疡、1 例直肠出血和 1 例不明原因的胃肠道穿孔，以及 1 例乙状结肠穿孔），严重副作用的总发生率为 14.3%。由于高剂量地塞米松严重副作用的发生率很高，因此放弃了该方案，转而采用每天 16 mg 的标准地塞米松剂量，并在 14 天内降至零。有 3 起事件被归类为副作用，但在 38 名连续接受该剂量的患者中，没有一个事件被认为是严重的。副作用总数和严重副作用数量的差异具有统计学意义。在接受高剂量地塞米松的组中，流动患者的数量没有显着差异。我们的结论是，根据我们的经验，高剂量的地塞米松会导致严重副作用的发生率高得令人无法接受，因此我们放弃了该方案，转而采用更标准的地塞米松剂量。
Twenty-eight consecutive patients were given high-dose dexamethasone (96 mg i.v. loading dose, decreasing doses to zero in 14 days) and radiotherapy for epidural spinal cord compression due to malignant disease. There were eight events classified as side effects of the dexamethasone treatment. Four of these were considered as serious (one fatal ulcer with haemmorhage, one rectal bleeding and one gastrointestinal perforation from undetermined origins, and one perforation of the sigmoid colon) giving a total rate of serious side effects of 14.3 percent. Due to the high incidence of serious side effects of the high dexamethasone dose, the regimen was abandoned in favor of a standard dexamethasone dose of 16 mg daily reduced to zero in 14 days. There were three events classified as side effects, but none were considered as serious in 38 consecutive patients receiving this dose. The differences both in total number of side effects and number of serious side effects are statistically significant. There was no significant difference in the number of ambulant patients in the group that received the high dexamethasone dose. We conclude that the high dexamethasone dose in our experience gives an unacceptably high incidence of serious side effects and we have therefore abandoned the regimen in favour of a more standard dexamethasone dose.