USE OF NAPROXEN IN AMELIORATING INDUCED PARANEOPLASTIC FEVER

The purpose of this study was to investigate the use of naproxen in pa tients with paraneoplastic fever. In total, 82 patients were entered i n this trial. Tumours diagnosed histologically were: breast 12, testes 2, colorectal 16, lung 15, head and neck 13, renal 6, unknown origin 8, pancreas 3, ovarian 2, cervix uteri 2, gastric 3, melanomas 2 and s arcomas 2. A clinical methodology was followed in order to exclude any possibility of infection. After 5 days of persistent unexplained feve r >38 degrees C without any incidence of infection and despite adequat e antibiotic treatment, the fever was attributed to the malignancy and patients were treated with oral naproxen 250mg twice a day at 12-hour ly intervals. Fever was monitored for 10 days after initiation of trea tment with naproxen. Of the 82 patients who received this drug, 18 pat ients (22%) did not respond to therapy. We then re-evaluated those 18 patients for the possibility of infection: 6 were found to suffer from microbial infections, and 8 received new empiric antibiotic treatment ; of these 8, 4 responded. Among the remaining 4 nonresponders, one wa s found to have a rectal abscess, and the other 3 died shortly afterwa rds; we were thus unable to follow them up completely. We therefore co ncluded that the use of nonsteroidal anti-inflammatory drugs, particul arly naproxen, in the treatment of paraneoplastic fever is successful in 78% of patients. The persistence of fever in patients who received naproxen might be attributed to an infectious cause.