Tomíska M, Tomisková M, Salajka F, Adam Z, Vorlícek J
Department of Internal Medicine-Hematooncology, Masaryk University Hospital, 62500 Brno, Czech Republic.
Neoplasma. 2003;50(3):227-33.
Megestrol acetate (MA) is a progestational agent, currently known as one of the most effective appetite stimulants in patients suffering from cancer anorexia/cachexia syndrome. Oral suspension of this drug may be particularly useful in patients with far advanced disease, where taking larger amount of pills may lead to the decrease of patient compliance. The influence of oral MA suspension on quality of life and nutritional status was evaluated in 22 patients with far advanced cancer suffering from anorexia and more than 5 per cent weight loss, all beyond the scope of anticancer treatment. Most patients had lung or gastrointestinal cancer. QLQ-C30 questionnaire, visual analogue scale (VAS) for appetite, anthropometry, maximal handgrip strength and laboratory data were obtained before treatment and then after 2, 4, and 8 weeks of therapy. Despite of a known high mortality in this prognostically unfavorable group of patients (36% within two months in this study), overall quality of life after the daily dose of 480-840 mg of MA was improved in 63, 56, and 55% of patients remaining on therapy after 2, 4, and 8 weeks, respectively. Appetite was the most successfully influenced parameter with an improvement in VAS in 95% of cases after 2 weeks of therapy (p=0.0001). The drug was well tolerated by the great majority of patients. Oral suspension of megestrol acetate maybean effective palliative treatment for many patients with far advanced cancer suffering from anorexia/cachexia syndrome.
醋酸甲地孕酮（MA）是一种孕激素类药物，目前被认为是治疗癌症厌食/恶病质综合征患者最有效的食欲刺激剂之一。这种药物的口服混悬剂对于疾病晚期患者可能特别有用，因为服用大量片剂可能会导致患者依从性下降。对22例晚期癌症且患有厌食症、体重减轻超过5%且均超出抗癌治疗范围的患者，评估了醋酸甲地孕酮口服混悬剂对生活质量和营养状况的影响。大多数患者患有肺癌或胃肠道癌。在治疗前以及治疗2、4和8周后，获取QLQ-C30问卷、食欲视觉模拟量表（VAS）、人体测量数据、最大握力和实验室数据。尽管在这个预后不良的患者群体中已知死亡率很高（本研究中两个月内为36%），但每日剂量480 - 840 mg的MA治疗后，分别在治疗2、4和8周后仍在接受治疗的患者中，生活质量总体改善率分别为63%、56%和55%。食欲是最受影响的参数，治疗2周后95%的患者VAS评分有所改善（p = 0.0001）。绝大多数患者对该药物耐受性良好。醋酸甲地孕酮口服混悬剂可能是许多患有厌食/恶病质综合征的晚期癌症患者的一种有效的姑息治疗方法。
