EFFECT OF MEGESTROL-ACETATE AND PREPULSID ON NUTRITIONAL IMPROVEMENT IN PATIENTS WITH HEAD AND NECK CANCERS UNDERGOING RADIOTHERAPY

Background nod purpose: Anorexia is a common problem in cancer patient s who receive radiotherapy. In this current study, we attempt to deter mine the effect of megestrol acetate and prepulsid on appetite and nut ritional improvement in patients with head and neck cancers undergoing radiotherapy. Materials and Methods: One hundred twenty-nine consecut ive patients with head and neck cancers treated between July 1993 and June 1993 were prospectively randomized to receive either megestrol ac etate, 40 mg qid (megace group), prepulsid, 5 mg lid (cisapride group) , or a placebo treatment (control group) during radiotherapy. Before r adiotherapy, body weight (kg), appetite score, performance status, bio chemical parameters and hematological parameters were evaluated, and t he above-noted clinical and biochemical parameters were assessed and r ecorded every other week. All patients received 6- 10 MV X-rays or Co- 60 gamma-ray to head and neck region for a full course of radiotherapy , 61.2-75.6 Gy/7-9 weeks. Results: Forty-eight patients were enrolled in the megace group, 41 patients in the cisapride group, and 40 patien ts in the control group. At the 2nd, 4th, 6th and 8th week, as the rad iation dose escalated, the megace group had significantly less body we ight loss than did the cisapride and control groups (P = 0.045, 0.024, 0.006, 0.003, respectively). The appetite scores of the megace group were significantly higher than those of the cisapride and control grou ps (P = 0.0001). However, there were no statistically significant diff erences in the change of albumin level among these three groups at the 2nd, 4th, 6th and 8th week (P > 0.05, respectively). Conclusions: Meg estrol acetate can significantly decrease the degree of body weight lo ss, and can prevent the deterioration of appetite in patients with hea d and neck cancers receiving radiotherapy. However, prepulsid lacks th e above-mentioned clinical benefits. (C) 1997 Elsevier Science Ireland Ltd.