title: Avascular necrosis of bone: the hidden risk of glucocorticoids used as antiemetics in cancer chemotherapy.
abstract: The role of antiemetics is invaluable in allowing cancer patients to complete otherwise potentially intolerable chemotherapy. Corticosteroids have an established place in the prevention and treatment of nausea and vomiting due to emetogenic cytotoxic agents. Avascular necrosis of bone is a recognised complication of glucocorticoid treatment--the risk of this increasing with higher doses and longer duration of use. This report details a case of bilateral avascular necrosis of the femoral heads in a patient receiving 'standard' doses of dexamethasone as part of the antiemetic regimen used in cisplatin-based combination chemotherapy.
authors.affiliation: Department of Medical Oncology, Guy's Hospital, London.
authors.forename: K
authors.initials: K
authors.lastname: Virik
authors.forename: C
authors.initials: C
authors.lastname: Karapetis
authors.forename: S
authors.initials: S
authors.lastname: Droufakou
authors.forename: P
authors.initials: P
authors.lastname: Harper
mesh_terms: D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D005271:Femur Head Necrosis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011859:Radiography; D013736:Testicular Neoplasms / Q000188:drug therapy
chemical_list: D000932:Antiemetics; D003907:Dexamethasone