J Korean Med Sci.  2013 May;28(5):687-692. 10.3346/jkms.2013.28.5.687.

Safety of Megestrol Acetate in Palliating Anorexia-Cachexia Syndrome in Patients with Castration-Resistant Prostate Cancer

• Hong S
• Jeong IG
• You D
• Lee JL
• Hong JH
• Ahn H
• Kim CS

• KMID: 1777555
• DOI: http://doi.org/10.3346/jkms.2013.28.5.687

Abstract

There are concerns whether megestrol acetate (MA) stimulates the growth of prostate cancer in castration-resistant prostate cancer (CRPC). We evaluated the effect of cumulative doses of MA on the disease-specific survival (DSS) in patients with CRPC who were receiving Docetaxel-based chemotherapy. From July 2003 through June 2009, we identified 109 consecutive patients with CRPC and who had received docetaxel-based chemotherapy. Of these patients, 68 (62.4%) have not received MA, whereas 21 patients (19.3%) and 20 patients (18.3%) had received low dose MA (total < or = 18,400 mg) and high dose MA (total > 18,400 mg), respectively. We assessed the effect of several variables on DSS. None of the clinicopathological variables differed among the three groups. When comparing DSS using Kaplan-Meier analysis, there was no statistically significant survival differences among the three groups (P = 0.546). Using multivariate Cox proportional analyses with backward elimination, the number of docetaxel cycles was only significant factor predicting DSS (HR: 0.578, 95% CI: 0.318-0.923, P = 0.016). Cumulative doses of MA as adjuvant treatment for patients with CRPC and who are receiving docetaxel-based chemotherapy, did not affect their DSS. Therefore, MA can be safely administered in cachexic patients with CRPC.

Keyword

Cachexia; Castration-Resistant Prostate Cancer; Docetaxel; Megestrol Acetate; Survival

MeSH Terms

Aged
Aged, 80 and over
Anorexia/complications/*drug therapy
Antineoplastic Agents/therapeutic use
Antineoplastic Agents, Hormonal/*therapeutic use
Cachexia/complications/*drug therapy
Castration
Humans
Kaplan-Meier Estimate
Male
Megestrol Acetate/*therapeutic use
Middle Aged
Proportional Hazards Models
Prostatic Neoplasms/complications/*drug therapy/mortality
Taxoids/therapeutic use
Antineoplastic Agents
Antineoplastic Agents, Hormonal
Taxoids
Megestrol Acetate

Figure

• 

  Fig. 1 Kaplan-Meier survival curve for disease-specific survival. There was no significant difference among the three groups (log rank P = 0.546).

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