Megestrol acetate therapy for anorexia and weight loss in children with malignant solid tumours

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Abstract
Malnutrition is very frequent in childhood cancer. Its main cause is inadequate intake for energy demands owing to lack of appetite. Megestrol acetate is a synthetic progestin that has been used for reversing anorexia in adult cancer. To assess megestrol acetate efficacy and side-effects in treating anorexia in childhood cancer. Thirty-five children with solid tumours were receiving antitumour therapy. Nutritional assessment was by anthropometry. Megestrol acetate efficacy was assessed by evaluating grade of appetite, energy intake and well-being. Side-effects were evaluated by means of clinical history, physical examination, lipid profile, coagulation tests and cortisol rhythm. When compared to baseline all the anthropometric measurements increased (P < 0.05) from the first month of megestrol acetate therapy, as well as appetite and energy intake. No significant side-effects were found. Megestrol acetate therapy is a powerful appetite stimulant which led to weight gain, composed of both fat mass and fat-free mass. Megestrol acetate is well tolerated, with few and mild side-effects. If megestrol acetate therapy is started at the onset of anorexia, the use of more expensive, invasive and complicated techniques of nutritional support may be avoided.

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