Study on Risk Factors for Hiccups Induced by Cisplatin-based Chemotherapy

Hiccups often occur in patients receiving cisplatin (CDDP)-based chemotherapy.In the present study,we investigated the incidence of hiccups in 162 patients who received CDDP as well as risk factors for developing hiccups.Hiccups occurred in 40 (25%) of the 162 patients,and 93% were men.Twenty-six of the patients had hiccups within 48 hr of CDDP,and in 31 of them the hiccups continued for between 1 and 4 days.Twenty-eight of the patients received medication (shitei-decoction,chlorpromazine,metoclopramide,etc.) to relieve hiccups,which was effective in 30% of them.Hiccups developed in patients with osteochondro sarcoma (56%),lung cancer (49%),pancreatic cancer (40%) and esophagus cancer (23%) receiving the following 4 chemotherapy regimens : CDDP+ADM+CAF (56%),CDDP+DTX (50%),CDDP+5 FU (40%),and CDDP+TS 1 (20%) respectively.The CDDP dosage (mg/m2)was higher in patients who had hiccups than in those who had none (80±22 vs 45±33,p< 0.0001)and there was a positive correlation was between CDDP dosage and incidence of hiccups (p<0.001),though all patients developing them received corticosteroids and 5 HT3 antagonists.Multiple logistic regression analysis showed that there were significant differences for the male sex (odds ratio (OR)=8,95% CI=1.5-45.6),CDDP dose (1.03,1.01-1.06),dexamethasone(≥16 mg) (19.4,3.9-95.2)and granisetron (6 mg) (20.9,3-143).We therefore concluded that the independent risk factors influencing the development of hiccups were the male sex and a high dose of CDDP in combination with dexamethasone(≥16 mg),and granisetron (6 mg).