Prophylactic Versus Reactive Megestrol Acetate Use for Critical Body Weight Loss in Patients with Pharyngeal and Laryngeal Squamous Cell Carcinoma Undergoing Concurrent Chemoradiotherapy.

IF 2 4区医学 Q3 NUTRITION & DIETETICS

Nutrition and Cancer-An International Journal Pub Date : 2024-01-01 Epub Date: 2024-05-17 DOI:10.1080/01635581.2024.2352185

Chien-Yu Lin, Pei-Wei Huang, Chia-Hsun Hsieh, Cheng-Lung Hsu, Chi-Ting Liau, Shiang-Fu Huang, Chun-Ta Liao, Tung-Chieh Chang, Hung-Ming Wang

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Abstract

This study compared the effects of megestrol acetate (MA) prophylactic (p-MA) versus reactive (r-MA) use for critical body-weight loss (>5% from baseline) during concurrent chemoradiotherapy (CCRT) in patients with advanced pharyngolaryngeal squamous cell carcinoma (PLSCC).

Patients receiving CCRT alone in two phase-II trials were included for analyses. Both the p-MA and r-MA cohorts received the same treatment protocol at the same institution, and the critical body-weight loss, survival, and adverse event profiles were compared.

The mean (SD) weight loss was 5.1% (4.7%) in the p-MA cohort (n = 54) vs. 8.1% (4.6%) in the r-MA cohort (n = 50) (p = .001). The percentage of subjects with body-weight loss >5% was 42.6% in the p-MA cohort vs. 68.0% in the r-MA cohort (p = .011). Tube feeding was needed in 22.2% of p-MA vs. 62.0% of r-MA patients (p < .001). Less neutropenia (26.0% vs. 70.0% [p < .001]) and a shorter duration of grade 3-4 mucositis (2.4 ± 1.4 vs. 3.6 ± 2.0 wk [p = .009]) were observed with p-MA treatment. Disease-specific survival, locoregional control, or distant metastasis-free survival did not differ. Less competing mortality from secondary primary cancer resulted in a better overall survival trend in the p-MA cohort.

p-MA may reduce body-weight loss and improve adverse event profiles during CCRT for patients with PLSCC.

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咽和喉鳞状细胞癌患者同时接受化放疗时，预防性使用醋酸甲地孕酮与反应性使用醋酸甲地孕酮治疗临界体重减轻。

这项研究比较了在晚期咽喉鳞状细胞癌（PLSCC）患者接受同期化放疗（CCRT）期间，醋酸甲地孕酮（MA）预防性（p-MA）和反应性（r-MA）治疗临界体重减轻（比基线减轻>5%）的效果。p-MA队列和r-MA队列在同一机构接受了相同的治疗方案，并对临界体重减轻、存活率和不良事件情况进行了比较。p-MA队列（n = 54）的平均（标清）体重减轻率为5.1%（4.7%），而r-MA队列（n = 50）的平均（标清）体重减轻率为8.1%（4.6%）（p = .001）。体重减轻>5%的受试者比例在p-MA队列中为42.6%，而在r-MA队列中为68.0%（p = .011）。在p-MA治疗中观察到，22.2%的p-MA患者需要插管喂养，而62.0%的r-MA患者需要插管喂养（p p = .009]）。疾病特异性生存率、局部控制率或无远处转移生存率没有差异。p-MA可减少PLSCC患者的体重减轻，并改善CCRT期间的不良反应情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition and Cancer-An International Journal 医学-营养学

CiteScore

5.80

自引率

3.40%

发文量

172

审稿时长

3 months

期刊介绍： This timely publication reports and reviews current findings on the effects of nutrition on the etiology, therapy, and prevention of cancer. Etiological issues include clinical and experimental research in nutrition, carcinogenesis, epidemiology, biochemistry, and molecular biology. Coverage of therapy focuses on research in clinical nutrition and oncology, dietetics, and bioengineering. Prevention approaches include public health recommendations, preventative medicine, behavior modification, education, functional foods, and agricultural and food production policies.