Supportive treatment in weight-losing cancer patients due to the additive adverse effects of radiation treatment and/or chemotherapy

The reversal of anorexia and weight loss especially in patients with advanc ed cancer suffering from radiation treatment (RT) -related complications an d debilitated furtherly during RT would be a welcome relief. The purpose of this study is to evaluate the feasibility of supportive treatment with meg estrol acetate (MA) in our weight-losing cancer patients increasingly exper iencing anorexia, smell, taste, and weight loss due to the additive adverse effects of RT +/- chemotherapy and how MA changes the additive role of the severity of RT reactions on such patients. From June 1997 to October 1998, 100 eligible patients were enrolled on a ra ndomized, placebo-controlled clinical trial. Of the 100 patients, 46 receiv ed MA during RT and 4 after the end of the RT, and 50 received placebo for 3 months. Subjective parameters were assessed by a brief questionnaire form based on scoring from 1 to 5, according to the degree of the loss or chang e for each parameter of malnutrition, appetite, taste and smell developed b y us. At the end of the study a statistically significant weight gain was achieve d in the patient group receiving MA compared to the placebo group (+ 3 to 5 kg versus -3.7 to -5.9 kg, p=0.000). Significant improvements were seen i n performance status (p=0.000), appetite (p=0.000), malnutrition (p=0.000), loss of taste (p=0.000) and smell qualities (p=0.02) in the MA group compa red to the placebo group. In the MA group there was no statistically signif icant difference related to the weight changes according to the grade of ei ther the acute or late RT effects (p=0.65 and 0.07, respectively). Whereas, in the placebo group a statistically significant additive effect of the ac ute and late RT effects was detected on weight loss (p=0.008 and 0.007, res pectively). We observed no side-effects of MA in a 3-month time follow-up. The use of MA 480 mg/day during RT was effective in reversing anorexia and weight loss in spite of the acute RT effects, and helped most patients to w ell tolerate specific tumor therapy. Further evaluation of its mechanisms o f action on RT-related adverse effects, tumor response relationships, and e ffect on patient survival are researched.