MEGESTROL-ACETATE THE THERAPY FOR ANOREXIA AND WEIGHT-LOSS IN CHILDREN - WITH MALIGNANT SOLID TUMORS

Background: Malnutrition is very frequent in childhood cancer. Its mai n cause is inadequate intake for energy demands owing to lack of appet ite. Megestrol acetate is a synthetic progestin that has been used for reversing anorexia in adult cancer. Objectives: To assess megestrol a cetate efficacy and side-effects in treating anorexia in childhood can cer. Methods: Thirty-five children with solid tumours were receiving a ntitumour therapy. Nutritional assessment was by anthropometry. Megest rol acetate efficacy was assessed by evaluating grade of appetite, ene rgy intake and well-being. Side-effects were evaluated by means of cli nical history, physical examination, lipid profile, coagulation tests and cortisol rhythm. Results: When compared to baseline all the anthro pometric measurements increased (P < 0.05) from the first month of meg estrol acetate therapy, as well as appetite and energy intake. No sign ificant side-effects were found. Conclusion: Megestrol acetate therapy is a powerful appetite stimulant which led to weight gain, composed o f both fat mass and fat-free mass. Megestrol acetate is well tolerated , with few and mild side-effects. If megestrol acetate therapy is star ted at the onset of anorexia, the use of more expensive, invasive and complicated techniques of nutritional support may be avoided.