The Effect of Megestrol Acetate on Nutritional Improvement for the Head and Neck Cancer Patients during Radiotherapy

Purpose: To determine the effect of megestrol acetate on nutritional improvement for the head and neck cancer patients during radiotherapy. Materials and Methods: Sixty-five consecutive patients of head and neck cancer treated between July, 1993 and June, 1994 were prospectively randomized to receive megestrol acetate, Megace, 40mg qid, (Megace group) or placebo treatment (control group) during radiotherapy. Before radiotherapy, body weight (kg), appetite score, performance status, biochemical parameters and hematological parameters were evaluated. The above clinical and biochemical parameters were assessed and recorded every other week. All patients received 6 MV X-ray or Co60-ray for full course of radiotherapy, 64.8-75.6 Gy/7-9 weeks. Result: Thirty-five patients were enrolled in Megace group and 30 patients in control group. At the 4th, 6th and 8th week, as radiation dose escalated, the Megace group had less body weight loss, than the control group (p=0.0l2, 0.003, 0.008, respectively). Significant lower appetite score was noted in control group as compared with Megace group (p=0.03, 0.01, 0.004, respectively). However, there were no significant difference in the change of prealbumin and albumin level between these two groups at the 2nd, 4th, 6th and 8th week (p＞0.005, respectively). Conclusion: Low dose megestrol acetate can significantly decrease the degree of body weight loss and deterioration of the appetite status for the head and neck cancer patients receiving conventional radiotherapy.