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| |  DG DISPATCH - ASTRO: Megestrol Maintains Weight, Appetite In Cancer Patients By Maria Bishop Special to DG News
BOSTON, MA -- October 25, 2000 -- Patients with both lung cancer and head and neck (H/N) cancer may find it easier to keep up their strength during radiation therapy thanks to prophylactic doses of megestrol acetate. At the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in Boston, Massachusetts, a phase-III trial was described in which 56 adults with head and neck (H/N) cancer received the progestational agent as a prophylactic treatment for weight loss. Weight loss is a frequent problem in cancer patients undergoing curative radiation therapy, noted the researchers, and megestrol acetate has been effectively used to manage the anorexia, cachexia and weight loss that occurs in advanced/metastatic disease. This placebo-controlled, double-blind, randomized trial took place over the course of 12 weeks, and was led by Richard P. McQuellon, PhD, Associate Professor, Director of Psychosocial Oncology and Cancer Patient Support Programs, department of Hematology & Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. All participants in this trial had either 1) head and neck cancer (either squamous-cell carcinoma [SCC] or lymphoepithelioma of the oral cavity, oral pharynx, nasopharynx or larynx) or 2) lung cancer (both non-small-cell and small-cell). Life expectancy for these patients was not high. Participants were randomised to therapy or placebo. Those in the therapy arm received 800 mg of megestrol acetate daily (20 mL orally each morning), beginning within three days of radiation therapy, over a 12-week period. Radiotherapy for all patients comprised a total dose of at least 50 Gy, either alone or with chemotherapy. Assessments were made at baseline, week 4, week 8 and week 12. At 12 weeks, those patients on the megestrol acetate arm had lost a mean average of 1.27 kg-a significant difference when compared to the placebo patients, who had lost a mean average of 4.9 kg. Patient-reported quality of life did not differ between the two arms, however, significant differences were observed in several subscales. H/N-cancer patients on megestrol acetate reported a greater ability to "eat as much as they liked" at 12 weeks. Lung-cancer patients on megestrol acetate reported a "better appetite" at all time points. When side effects were examined, Grade 1-3 nausea was less common on the therapy arm, but Grade 1-2 pulmonary toxicity (dyspnea, cough) was more common among those taking megestrol acetate. "Although the overall quality-of-life scores were similar on the two arms," Dr. McQuellon noted, "the results on individual items like appetite and the ability to eat were better in those patients treated with megestrol acetate."
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