Regular Article

British Journal of Cancer (1999) 79, 495–500. doi:10.1038/sj.bjc.6690077 www.bjcancer.com
Published online 14 January 1999

A prospective randomized study of megestrol acetate and ibuprofen in gastrointestinal cancer patients with weight loss

D C McMillan1, S J Wigmore2, K C H Wigmore2, P O'Gorman1, C E Wright2 and C S McArdle1

  1. 1University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK
  2. 2University Department of Surgery, Royal Infirmary, Edinburgh EH3 9YW, UK

Correspondence: DC McMillan, University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK

Received 30 December 1997; Revised 14 April 1998; Accepted 28 May 1998.

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Abstract

The use of megestrol acetate in the treatment of weight loss in gastrointestinal cancer patients has been disappointing. The aim of the present study was to compare the combination of megestrol acetate and placebo with megestrol acetate and ibuprofen in the treatment of weight loss in such patients. At baseline, 4–6 weeks and 12 weeks, patients underwent measurements of anthropometry, concentrations of albumin and C-reactive protein and assessment of appetite, performance status and quality of life using EuroQol-EQ-5D and EORTC QLQ-C30. Thirty-eight and 35 patients (median weight loss 18%) were randomized to megestrol acetate/placebo or megestrol acetate/ibuprofen, respectively, for 12 weeks. Forty-six (63%) of patients failed to complete the 12-week assessment. Of those evaluable at 12 weeks, there was a decrease in weight (median 2.8 kg) in the megestrol acetate/placebo group compared with an increase (median 2.3 kg) in the megestrol acetate/ibuprofen group (P < 0.001). There was also an improvement in the EuroQol-EQ-5D quality of life scores of the latter group (P < 0.05). The combination of megestrol acetate/ibuprofen appeared to reverse weight loss and appeared to improve quality of life in patients with advanced gastrointestinal cancer. Further trials of this novel regimen in weight-losing patients with hormone-insensitive cancers are warranted.

Keywords:

prospective randomized study, gastrointestinal cancer, weight loss, megestrol acetate, ibuprofen, acute phase response

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