A randomized, double-blind, placebo-controlled clinical trial of megestrol acetate as an appetite stimulant in children with weight loss due to cancer and/or cancer therapy

Pediatric Blood and Cancer

Volumn 61, Issue 4, 2014, Pages 672-679

  Cuvelier, Geoff D E ^a   Baker, Tina J ^b   Peddie, Elaine F ^c   Casey, Linda M ^b,c   Lambert, Pascal J ^d   Distefano, Dianne S ^c   Wardle, Marlene G ^c   Mychajlunow, Beth A ^c   Romanick, Marcel A ^b   Dix, David B ^c   Wilson, Beverly A ^b  

^a UNIVERSITY OF MANITOBA   (Canada)

^b UNIVERSITY OF ALBERTA   (Canada)

^c UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^d CancerCare Manitoba ^*  (Canada)

Author keywords

Appetite stimulant; Megestrol acetate; Pediatric cancer; Randomized trial; Weight loss

Indexed keywords

ANTINEOPLASTIC AGENT; HYDROCORTISONE; INOTROPIC AGENT; MEGESTROL ACETATE; PLACEBO;

ADOLESCENT; ADRENAL DISEASE; ADRENAL SUPPRESSION; APPETITE; ARM CIRCUMFERENCE; ARTICLE; AUTOLOGOUS STEM CELL TRANSPLANTATION; BACTEREMIA; BODY MASS; BONE MINERAL; CANCER CHEMOTHERAPY; CANCER PATIENT; CANCER THERAPY; CHILD; CHILDHOOD CANCER; CLINICAL ARTICLE; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; DRUG DOSE REDUCTION; DRUG MEGADOSE; DRUG WITHDRAWAL; DUAL ENERGY X RAY ABSORPTIOMETRY; ENTERIC FEEDING; FAT MASS; FEBRILE NEUTROPENIA; FEMALE; HUMAN; HYPOTENSION; INCREASED APPETITE; ISCHEMIA; KLEBSIELLA PNEUMONIAE INFECTION; LEAN BODY WEIGHT; MALE; MULTICENTER STUDY; NEUTROPENIC ENTEROCOLITIS; PARENTERAL NUTRITION; PRESCHOOL CHILD; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SCHOOL CHILD; UNDERWEIGHT; WEIGHT GAIN; WEIGHT REDUCTION;

APPETITE STIMULANT; MEGESTROL ACETATE; PEDIATRIC CANCER; RANDOMIZED TRIAL; WEIGHT LOSS;

ADOLESCENT; ADULT; APPETITE; APPETITE STIMULANTS; CHILD; CHILD, PRESCHOOL; DOUBLE-BLIND METHOD; FEMALE; FOLLOW-UP STUDIES; HUMANS; INFANT; MALE; MEGESTROL ACETATE; NEOPLASM STAGING; NEOPLASMS; NUTRITION DISORDERS; PROGNOSIS; QUALITY OF LIFE; WEIGHT LOSS; YOUNG ADULT;

EID: 84893489945     PISSN: 15455009     EISSN: 15455017     Source Type: Journal    
DOI: 10.1002/pbc.24828     Document Type: Article

References (33)

1. Brinksma A, Huizinga G, Sulkers E, et al. Malnutrition in childhood cancer patients: A review on its prevalence and possible causes. Crit Rev Oncol Hematol 2012; 83:249-275.
2. Ward E, Hopkins M, Arbuckle L, et al. Nutritional problems in children treated for medulloblastoma: Implications for enteral nutrition support. Pediatr Blood Cancer 2009; 53:570-575.
3. Rickard KA, Detamore CM, Coates TD, et al. Effect of nutrition staging on treatment delays and outcome in Stage IV neuroblastoma. Cancer 1983; 52:587-598.
4. Taj MM, Pearson AD, Mumford DB, et al. Effect of nutritional status on the incidence of infection in childhood cancer. Pediatr Hematol Oncol 1993; 10:283-287.
5. Donaldson SS, Wesley MN, DeWys WD, et al. A study of the nutritional status of pediatric cancer patients. Am J Dis Child 1981; 135:1107-1112.
6. Sala A, Rossi E, Antillon F, et al. Nutritional status at diagnosis is related to clinical outcomes in children and adolescents with cancer: A perspective from Central America. Eur J Cancer 2012; 48:243-252.
7. Lange BJ, Gerbing RB, Feusner J, et al. Mortality in overweight and underweight children with acute myeloid leukemia. JAMA 2005; 293:203-211.
8. Rogers PC, Melnick SJ, Ladas EJ, et al. Children's Oncology Group (COG) Nutrition Committee. Pediatr Blood Cancer 2008; 50:447-450, discussion 451.
9. Ruiz Garcia V, Lopez-Briz E, Carbonell Sanchis R, et al. Megestrol acetate for treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev 2013; CD004310.
10. Azcona C, Castro L, Crespo E, et al. Megestrol acetate therapy for anorexia and weight loss in children with malignant solid tumours. Aliment Pharmacol Ther 1996; 10:577-586.
11. Couluris M, Mayer JL, Freyer DR, et al. The effect of cyproheptadine hydrochloride (periactin) and megestrol acetate (megace) on weight in children with cancer/treatment-related cachexia. J Pediatr Hematol Oncol 2008; 30:791-797.
12. Motil KJ. Sensitive measures of nutritional status in children in hospital and in the field. Int J Cancer Suppl 1998; 11:2-9.
13. Association WM. WMA Declaration of Helsinki-Ethical principles for medical research involving human subjects. http://www.wma.net/en/30publications/10policies/b3/index.html
14. Canada ADAaDo. Manual of clinical dietetics. Chicago, IL: American Dietetic Association; 2000. p 874.
15. Tolia V, Fitzgerald J, Hassall E, et al. Safety of lansoprazole in the treatment of gastroesophageal reflux disease in children. J Pediatr Gastroenterol Nutr 2002; 35:S300-S307.
16. Brady MT, Koranyi KI, Hunkler JA. Megestrol acetate for treatment of anorexia associated with human immunodeficiency virus infection in children. Pediatr Infect Dis J 1994; 13:754-756.
17. Marchand V, Baker SS, Stark TJ, et al. Randomized, double-blind, placebo-controlled pilot trial of megestrol acetate in malnourished children with cystic fibrosis. J Pediatr Gastroenterol Nutr 2000; 31:264-269.
18. Eubanks V, Koppersmith N, Wooldridge N, et al. Effects of megestrol acetate on weight gain, body composition, and pulmonary function in patients with cystic fibrosis. J Pediatr 2002; 140:439-444.
19. Nasr SZ, Hurwitz ME, Brown RW, et al. Treatment of anorexia and weight loss with megestrol acetate in patients with cystic fibrosis. Pediatr Pulmonol 1999; 28:380-382.
20. Dean A, Sullivan K, Arner T, et al. Epi Info 2000, a database and statistics program for publich heath professionals. Atlanta, GA: Centers for Disease Control; 2000.
21. van der Sluis IM, de Ridder MA, Boot AM, et al. Reference data for bone density and body composition measured with dual energy x ray absorptiometry in white children and young adults. Arch Dis Child 2002; 87:341-347, discussion 341-347.
22. Kelly TL, Wilson KE, Heymsfield SB. Dual energy X-Ray absorptiometry body composition reference values from NHANES. PloS ONE 2009; 4:e7038.
23. Ladas EJ, Sacks N, Brophy P, et al. Standards of nutritional care in pediatric oncology: Results from a nationwide survey on the standards of practice in pediatric oncology. A Children's Oncology Group study. Pediatr Blood Cancer 2006; 46:339-344.
24. Barr R, Collins L, Nayiager T, et al. Nutritional status at diagnosis in children with cancer. 2. An assessment by arm anthropometry. J Pediatr Hematol Oncol 2011; 33: e101-e104.
25. Co-Reyes E, Li R, Huh W, et al. Malnutrition and obesity in pediatric oncology patients: Causes, consequences, and interventions. Pediatr Blood Cancer 2012; 59:1160-1167.
26. Oguz A, Karadeniz C, Pelit M, et al. Arm anthropometry in evaluation of malnutrition in children with cancer. Pediatr Hematol Oncol 1999; 16:35-41.
27. Crabtree NJ, Kibirige MS, Fordham JN, et al. The relationship between lean body mass and bone mineral content in paediatric health and disease. Bone 2004; 35:965-972.
28. Loprinzi CL, Schaid DJ, Dose AM, et al. Body-composition changes in patients who gain weight while receiving megestrol acetate. J Clin Oncol 1993; 11:152-154.
29. Bauer J, Jurgens H, Fruhwald M. Important aspects of nutrition in children with cancer. Adv Nutr 2011; 2:67-77.
30. Prado C, Maia Y, Ormsbee M, et al. Assessment of nutritional status in cancer-The relationship between body composition and pharmacokinetics. Anticancer Agents Med Chem 2013; 13:1197-1203.
31. Meacham LR, Mazewski C, Krawiecki N. Mechanism of transient adrenal insufficiency with megestrol acetate treatment of cachexia in children with cancer. J Pediatr Hematol Oncol 2003; 25:414-417.
32. Chidakel AR, Zweig SB, Schlosser JR, et al. High prevalence of adrenal suppression during acute illness in hospitalized patients receiving megestrol acetate. J Endocrinol Invest 2006; 29:136-140.
33. Orme LM, Bond JD, Humphrey MS, et al. Megestrol acetate in pediatric oncology patients may lead to severe, symptomatic adrenal suppression. Cancer 2003; 98:397-405.