1.Safety of Megestrol Acetate in Palliating Anorexia-Cachexia Syndrome in Patients with Castration-Resistant Prostate Cancer.
Sungwoo HONG ; In Gab JEONG ; Dalsan YOU ; Jae Lyun LEE ; Jun Hyuk HONG ; Hanjong AHN ; Choung Soo KIM
Journal of Korean Medical Science 2013;28(5):687-692
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.
Aged
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Aged, 80 and over
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Anorexia/complications/*drug therapy
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Antineoplastic Agents/therapeutic use
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Antineoplastic Agents, Hormonal/*therapeutic use
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Cachexia/complications/*drug therapy
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Castration
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Humans
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Kaplan-Meier Estimate
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Male
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Megestrol Acetate/*therapeutic use
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Middle Aged
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Proportional Hazards Models
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Prostatic Neoplasms/complications/*drug therapy/mortality
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Taxoids/therapeutic use