SUPPORTIVE USE OF MEGESTROL-ACETATE IN PATIENTS WITH HEAD AND NECK-CANCER DURING RADIO(CHEMO)THERAPY

To study the supportive effect of megestrol acetate during intensive c ombined modality treatment, a randomised, double-blind, placebo-contro lled study was performed in patients with head and neck cancer. The pa tients received either 160 mg of megestrol acetate daily or placebo du ring radio(chemo)therapy and for up to 6 weeks thereafter. The nutriti onal status as measured by anthropometric and biochemical parameters a nd the subjective quality of life were assessed prior to therapy, at w eeks 1, 4 and 6 of radiotherapy and 12 and 18 weeks from the start of therapy. 61 of 64 patients were evaluable. In the control group (n = 3 0), the nutritional parameters deteriorated during therapy and were fu lly restored during follow-up. By contrast, the patients treated with megestrol acetate (n = 31) could maintain their baseline values. The d ifference between the groups was most pronounced in patients taking fo od per mouth (weight loss during treatment: control group: 4.1 kg; meg estrol acetate group: 0.8 kg, P = 0.0004), but was not significant in patients fed via percutaneous endoscopically guided gastrostomy (PEG). Subjective quality of Life remained constant in the megestrol acetate group while it decreased in the control group. However, differences w ere not statistically significant. Megestrol acetate prevents further deterioration of nutritional status during radio(chemo)therapy and may have an impact on subjective quality of life. (C) 1997 Elsevier Scien ce Ltd.