Megestrol acetate therapy for anorexia and weight loss in children with malignant solid tumours
Azcona C, Castro L, Crespo E, Jiménez M, Sierrasesúmaga L.
Department of Paediatrics, University Clinic, School of Medicine, Pamplona, Spain
Malnutrition is very frequent in childhood cancer. Its main cause is inadequate intake for energy demands owing to lack of appetite. Megestrol acetate is a synthetic progestin that has been used for reversing anorexia in adult cancer.
To assess megestrol acetate efficacy and side-effects in treating anorexia in childhood cancer.
Thirty-five children with solid tumours were receiving antitumour therapy. Nutritional assessment was by anthropometry. Megestrol acetate efficacy was assessed by evaluating grade of appetite, energy intake and well-being. Side-effects were evaluated by means of clinical history, physical examination, lipid profile, coagulation tests and cortisol rhythm.
When compared to baseline all the anthropometric measurements increased (P < 0.05) from the first month of megestrol acetate therapy, as well as appetite and energy intake. No significant side-effects were found.
Megestrol acetate therapy is a powerful appetite stimulant which led to weight gain, composed of both fat mass and fat-free mass. Megestrol acetate is well tolerated, with few and mild side-effects. If megestrol acetate therapy is started at the onset of anorexia, the use of more expensive, invasive and complicated techniques of nutritional support may be avoided.
CITATION Aliment Pharmacol Ther. 1996 Aug;10(4):577-86