tailieunhanh - Báo cáo khoa học: " Multifocal Stevens-Johnson syndrome after concurrent phenytoin and cranial and thoracic radiation treatment, a case repor"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài: Multifocal Stevens-Johnson syndrome after concurrent phenytoin and cranial and thoracic radiation treatment, a case report. | Kandil et al. Radiation Oncology 2010 5 49 http content 5 1 49 RADIATION ONCOLOGY CASE REPORT Open Access Multifocal Stevens-Johnson syndrome after concurrent phenytoin and cranial and thoracic radiation treatment a case report Abdullah O Kandil1 Tomas Dvorak2 John Mignano2 Julian KWu3 and Jay-Jiguang Zhu 4 5 Abstract A 46 year old male patient with metastatic prostate cancer developed Stevens-Johnson syndrome SJS initially in three well-demarcated areas on his scalp chest and back corresponding to ports of radiation therapy while on phenytoin. The rash spread from these locations and became more generalized and associated with pain and sloughing in the mucous lining of the mouth. There is a documented association between phenytoin administration with concurrent cranial radiation therapy and development of SJS. Erythema multiforme EM associated with phenytoin and cranial radiation therapy EMPACT is the term that describes this reaction. However this term may not cover the full spectrum of the disease since it describes EM associated with phenytoin and only cranial radiation therapy. This case report presents evidence that SJS may be induced by radiation to other parts of the body in addition to the cranium while phenytoin is administered concomitantly. With increasing evidence that phenytoin and levetiracetam are equally efficacious for seizure treatment and prophylaxis and since there is no link identified so far of an association between levetiracetam and SJS we believe that levetiracetam is a better option for patients who need anticonvulsant medication s while undergoing radiation therapy especially cranial irradiation. Background Patients with symptomatic metastases to osseous or soft tissues are frequently offered short courses of palliative external beam radiation. In the United States fractionation schedules of 8 Gy in 1 fraction to Gy delivered in 15 fractions is commonly used 1 . These treatments are generally well tolerated. The .

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