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高剂量皮质类固醇在无法手术的脑肿瘤患者中的应用。

Use of high dose corticosteroids in patients with inoperable brain tumours.

作者信息

Lieberman A, LeBrun Y, Glass P, Goodgold A, Lux W, Wise A, Ransohoff J

出版信息

J Neurol Neurosurg Psychiatry. 1977 Jul;40(7):678-82. doi: 10.1136/jnnp.40.7.678.

Abstract

Eleven patients with inoperable brain tumours were treated with high doses of corticosteroids (methylprednisolone 200-2000 mg/day) for up to 151 days (mean 55 days). Neurological improvement occurred in eight patients on high doses after deterioration on concentional doses (methylprednisolone 80-120 mg/day). In two patients steroids could be completely discontinued for several months. Serious adverse effects included sepsis in three patients and myopathy in tow. All three patients with sepsis also received chemotherapy. There were no deaths that could be attributed to steroids. The most likely effect of high dosage steroids is reduction of cerebral oedema. It is conceivable that in some instances high dose steroids may also result in tumour inhibition or oncolysis or both.

摘要

11例无法手术的脑肿瘤患者接受了高剂量皮质类固醇(甲泼尼龙200 - 2000毫克/天)治疗,最长达151天(平均55天)。8例患者在常规剂量(甲泼尼龙80 - 120毫克/天)治疗病情恶化后,改用高剂量治疗出现了神经功能改善。2例患者的类固醇药物可完全停用数月。严重不良反应包括3例患者发生败血症和2例患者出现肌病。所有3例败血症患者也接受了化疗。没有可归因于类固醇药物的死亡病例。高剂量类固醇最可能的作用是减轻脑水肿。可以想象,在某些情况下,高剂量类固醇也可能导致肿瘤抑制或肿瘤溶解或两者兼而有之。

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本文引用的文献

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USE OF GLUCOCORTICOIDS IN THE PALLIATIVE TREATMENT OF METASTATIC BRAIN TUMORS.糖皮质激素在转移性脑肿瘤姑息治疗中的应用
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