High incidence of serious side effects of high-dose dexamethasone treatment in patients with epidural spinal cord compression
Abstract
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 haemorrhage, 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.
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Emergent radiotherapy for spinal cord compression/impingement—a narrative review
Zaki, P. M., Barbour, A. B., Zaki, M. M., Tseng, Y. D., Amin, A. G., Venur, V. A., McGranahan, T. M., Vellayappan, B. A., Palmer, J. D., Chao, S. T., et al. (2023) · Annals of Palliative Medicine · doi:10.21037/apm-23-342 · Cited by 9 · see citing works
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Neurosurgical emergencies in spinal tumors: pathophysiology and clinical management
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- Authors
- Heimdal, K., Hirschberg, H., Sletteb�, H., Watne, K., & Nome, O.
- ORCID
- Heimdal, Ketil
- Venue
- Journal of Neuro-Oncology
- Published
- 1992-02
- Volume
- 12
- Issue
- 2
- Pages
- 141-4
- ISSN
- 0167-594X (ISSN-L)
- 1573-7373
- OpenAlex
- W2062550356
- Cited by
- 173
- References
- 6
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 3 · 2023: 7 · 2022: 11 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 18 · 2017: 10 · 2016: 4 · 2015: 7 · 2014: 2 · 2013: 6 · 2012: 11
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Neuro-Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Management of metastatic bone disease
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Surgery › Spinal Hematomas and Complications
- Keywords
- high-dose dexamethasone, epidural spinal cord compression, corticosteroid adverse effects, gastrointestinal perforation, rectal bleeding, sigmoid colon perforation, radiotherapy, dose reduction, ambulation, spinal metastases
- MeSH terms
- Aged, Aged, 80 and over, Combined Modality Therapy, Dexamethasone, Female, Humans, Male, Middle Aged, Spinal Cord Compression, Epidural Neoplasms, Incidence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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