PDF(Pubmed)
Abstract：
Steroids are commonly used for medical purposes. While hiccups are a recognized side effect of steroid therapy, we have not found any reports of hiccups interfering with the progress of radiotherapy. A case of dexamethasone (DEX)-induced hiccups (DIH) during CyberKnife radiotherapy (CKR) is presented. A 42-year-old man with neurofibromatosis type I had a history of malignant peripheral schwannomas originating in the right femur. We started to perform CKR with oral DEX at an increased dose of 4 mg/day for the recurrence of cranial metastasis and primary lesions. Severe hiccups developed four days after the increased DEX dose. DEX was stopped six days after CKR initiation, and the hiccups subsided over the next four days. However, the CKR procedure was not possible due to the patient\'s worsening swelling of the head and thigh lesions, which prevented the proper fit of the mesh face mask and body fixation device. Intravenous (IV) DEX 6.6 mg/day was initiated, which allowed the resumption of CKR due to reduced swelling of the lesions. The CKR was completed due to the absence of hiccups following the transition to IV DEX. DIH could occur even at a dosage of 4 mg/day when taken orally. Our case suggests the significance of recognizing DIH during radiotherapy. Switching the administration from oral to IV DEX may be an option for dealing with DIH.
摘要：
类固醇通常用于医疗目的。虽然打嗝是类固醇治疗的公认副作用，我们没有发现任何打嗝干扰放疗进展的报告。介绍了一例在射波刀放射治疗（CKR）期间地塞米松（DEX）引起的打嗝（DIH）。一名42岁的I型神经纤维瘤病患者有起源于右股骨的恶性外周神经鞘瘤的病史。我们开始以4mg/天的剂量口服DEX进行CKR，以治疗颅骨转移和原发性病变的复发。DEX剂量增加后四天出现严重打嗝。CKR启动后六天停止DEX，在接下来的四天里，打嗝消退了。然而,CKR手术是不可能的，由于患者的头部和大腿病变的加重肿胀，这阻碍了网状面罩和身体固定装置的正确配合。开始静脉（IV）DEX6.6mg/天，由于病变肿胀减少，这使得CKR恢复。由于过渡到IVDEX后没有打嗝，因此完成了CKR。当口服时,DIH甚至可以在4mg/天的剂量下发生。我们的案例表明在放疗期间识别DIH的重要性。将给药从口服转换为IVDEX可能是处理DIH的一种选择。
