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Initial bolus of conventional versus high-dose dexamethasone in metastatic spinal cord compression

Department of Neurology, Dr. Daniel den Hoed Cancer Center, Rotterdam (Dr. Vecht)
Biostatistics, Dr. Daniel den Hoed Cancer Center, Rotterdam (Mr. van Putten)
Department of Neurology, University Hospital, Groningen (Dr. Haaxma-Reiche)
Academic Medical Center, Amsterdam (Drs. de Visser and Vries)
University Hospital, Maastricht, The Netherlands (Dr. Twijnstra)

We randomly assigned dexamethasone in an initial bolus of 10 mg IV or 100 mg IV followed by 16 mg daily orally to 37 patients with metastatic spinal cord compression. The average pain score before the start of treatment was 5.2 (SD = 2.8) and decreased significantly (p < 0.001) to 3.8 at 3 hrs, 2.8 at 24 hrs, and 1.4 after 1 week. There were no differences between the conventional and high-dose group on pain, ambulation, or bladder function.

Address correspondence and reprint requests to Dr. Vecht, The Dr. Daniel den Hoed Cancer Center, Department of Neurology, PO Box 5201, 3008 AE Rotterdam, The Netherlands.

Received January 27, 1989. Accepted for publication in final form March 28, 1989.

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