Abstract:
UNASSIGNED: Nasopharyngeal carcinoma is an uncommon cancer but has a distinct racial and geographic distribution. Patient presents with constellation of signs and symptoms due to its vicinity to critical structures and are best treated by conformal concurrent chemo-radiotherapy. We present a case of 45-year-old male diagnosed with carcinoma nasopharynx, referred to us for radiotherapy after three cycles of neoadjuvant chemotherapy. As per the prevailing standard of care, patient was planned for radiotherapy by volumetric arc technique with concurrent cisplatin. Initial days of treatment were uneventful. After fourth week of treatment, patient developed persistent hiccup which was not relieved on conservative medications. Plan was re-evaluated and it revealed maximum dose of 54.6 Gy to the brainstem. Radiotherapy induced edema that could have stimulated vagus nerve leading to hiccups was suspected. Patient was started on injectable steroid and chlorpromazine. There was prompt recovery from the symptom within five days of conservative treatment.
摘要:
■鼻咽癌是一种罕见的癌症,但具有不同的种族和地理分布。患者由于靠近关键结构而出现一系列体征和症状,最好通过适形同步化学放射疗法进行治疗。我们介绍了一例45岁的男性被诊断为鼻咽癌,三个周期的新辅助化疗后,请我们接受放疗。根据现行的护理标准,患者计划通过体积电弧技术联合顺铂进行放疗。治疗的最初几天是平安无事的。治疗第四周后,患者出现持续性打嗝,保守药物治疗后仍未缓解.重新评估该计划,发现脑干的最大剂量为54.6Gy。怀疑放疗引起的水肿可能刺激迷走神经导致打嗝。患者开始注射类固醇和氯丙嗪。在保守治疗的五天内症状迅速恢复。