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

Cuvelier, Geoff D.E.; Baker, Tina J.; Peddie, Elaine F.; Casey, Linda; Lambert, Pascal; Distefano, Dianne S.; Wardle, Marlene G.; Mychajlunow, Beth A.; Romanick, Marcel; Dix, David; Wilson, Beverly

doi:10.1002/pbc.24828

Cited by 48 publications

(78 citation statements)

References 32 publications

(37 reference statements)

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“…This indicates that any method to prevent weight loss or prompt weight restoration could potentially improve the prognosis in these patients. Interventions to address weight loss in cancer patients, such as nutritional support (Koretz, 2007;Baldwin et al, 2012), appetite stimulants (Cuvelier et al, 2014), inhibitors of inflammatory cytokines (Gordon et al, 2005;Schmitz and Ecker, 2008;Mocellin et al, 2013), anti-inflammatory agents (Lundholm et al, 2004), anabolic agents (Dalton et al, 2013), and exercise training (Oldervoll et al, 2011;Argiles et al, 2012), have been investigated widely. Although some results have been encouraging, there is still lack of an adequate evidence base for its therapy.…”

Section: Discussionmentioning

confidence: 99%

Weight Loss Correlates with Macrophage Inhibitory Cytokine-1 Expression and Might Influence Outcome in Patients with Advanced Esophageal Squamous Cell Carcinoma

Lu¹,

Li²,

Yu³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Weight loss during chemotherapy has not been exclusively investigated. Macrophage inhibitory cytokine-1 (MIC-1) might play a role in its etiology. Here, we investigated the prognostic value of weight loss before chemotherapy and its relationship with MIC-1 concentration and its occurrence during chemotherapy in patients with advanced esophageal squamous cell carcinoma (ESCC). Materials and Methods: We analyzed 157 inoperable locally advanced or metastatic ESCC patients receiving first-line chemotherapy. Serum MIC-1 concentrations were assessed before chemotherapy. Patients were assigned into two groups according to their weight loss before or during chemotherapy:>5% weight loss group and≤5% weight loss group. Results: Patients with weight loss>5% before chemotherapy had shorter progression-free survival period (5.8 months vs. 8.7 months; p=0.027) and overall survival (10.8 months vs. 20.0 months; p=0.010). Patients with weight loss >5% during chemotherapy tended to have shorter progression-free survival (6.0 months vs. 8.1 months; p=0.062) and overall survival (8.6 months vs. 18.0 months; p=0.022), and if weight loss was reversed during chemotherapy, survival rates improved. Furthermore, serum MIC-1 concentration was closely related to weight loss before chemotherapy (p=0.001) Conclusions: Weight loss both before and during chemotherapy predicted poor outcome in advanced ESCC patients, and MIC-1 might be involved in the development of weight loss in such patients.

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Section: Discussionmentioning

confidence: 99%

Weight Loss Correlates with Macrophage Inhibitory Cytokine-1 Expression and Might Influence Outcome in Patients with Advanced Esophageal Squamous Cell Carcinoma

Lu¹,

Li²,

Yu³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…e) Çalışmanın Sonuçlarının Açıklığı: Çalışma kapsamına alınan sekiz çalışmanın sonuçları açık bir şekilde belirtilmiş, bir çalışmanın sonucu ise belirtilmemiştir (Tablo II). Çalışma kapsamına alınan makale sonuçları kullanılan beslenme ürünleri yönünden incelendiğinde, aktif kemoterapi tedavisi gören kanserli çocuklarda yoğun protein ve enerji içeren oral eikosapentaenoik asit takviyesinin kilo kaybında azalma sağladığı ve kanserli çocuklarda kullanımının uygun olduğu, yüksek riskli kanserli çocuklarda megesterol asetatın rölatif ağırlıkta artış sağladığı, glutaminin yüksek doz kemoterapi ve radyoterapinin risklerini azaltmada yararlı olduğu ve özellikle kemik iliği transplantasyonu olan hastalarda kullanımının avantajlı olduğu, pediatrik onkoloji hastaları tarafından taze süt bazlı oral besin takviyelerinin tercih edildiği, piyasada mevcut olan hazır ürünlerin hastanede hazırlanan ürünlere oranla daha kabul edilir ve tercih edilir olduğu belirlenmiştir (20)(21)(22)(23) (27,28). Genelde değişkenler arasındaki ilişkilerin net gösterilebilmesi açısından örneklem büyüklüğünün yüzün üstü olması önerilmektedir.…”

Section: çAlışmaların Seçimi Ve Araştırmaların Değerlendirilmesiunclassified

“…İncelenen dokuz çalışmanın altısı beslenme ürünlerini ve üçü beslenme yöntemlerini ayrıntılı olarak tanımlamışlardır (Tablo II). Bu başlık altında çalışmaların tamamının deneysel ve randomize kontrol ilkesini yerine getirdiği ve yarısının randomizasyonunu çift körleme yöntemi ile yapıldığı belirlenmiştir (21,23,30,32). e) Çalışmanın Sonuçlarının Açıklığı: Çalışma sonuçlarının okunabilirliği ve uygulanabilirliği için, bulgular ve sonuçlar açıkça belirtilmeli, gerekli ise şekil ve tablo konulmalı ve sonuçlar açık ve sade olmalıdır (33).…”

Section: C) Veri Toplama Yönteminin Etkinliğiunclassified

“…Çalışma kapsamına alınan sekiz çalışmanın sonuçları açık bir şekilde belirtilmiş, bir çalışmanın sonucu ise belirtilmemiştir (32) (Tablo II). Ayrıca, çalışma kapsamına alınan çalışmalarda yüksek protein ve enerji içeren ürünlerin kilo kaybında azalma sağladığı, proaktif beslenme tüpü ve gastrostomi tüpünün kanserli çocuklarda kullanımının uygun olduğu, beslenme ürünü olarak glutaminin ve megestrol asetatın kanserli çocuklarda kullanımın uygun olduğu ve parenteral beslenmenin enteral beslenmeden daha etkili olduğu belirlenmiştir (20)(21)(22)(24)(25)(26).…”

Section: C) Veri Toplama Yönteminin Etkinliğiunclassified

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Nutrition in Pediatric Oncology Patients: A Systematic Review

Kudubeş¹,

Bektaş²

2016

jpr

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“…The vast majority of these papers employed a case-series or case-control design, placing limitations on the strengths of their conclusions. Those studies that were randomized and controlled 22,34,39 tended to have a small sample size (all <50). The outcome measures used were variable, with an emphasis on weight and BMI.…”

mentioning

confidence: 99%

Interventions for managing weight change following paediatric acquired brain injury: a systematic review

Shah

Lodh

Siddell

et al. 2016

Develop Med Child Neuro

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ABI Acquired brain injury BMIBody mass index TBI Traumatic brain injury OBJECTIVE To systematically review literature reporting interventions for weight change following paediatric acquired brain injury (ABI).METHOD A systematic search of the literature was conducted using advanced search techniques. The retrieval identified 1562 papers, of which 30 were relevant. The total number of paediatric participants was 759. RESULTSThere is a paucity of higher quality evidence to support the use of weight change interventions following paediatric ABI. Substantial variation in screening, outcome measures, intervention, and reporting were demonstrated. Some support was found for the use of hypothalamic-sparing surgery as a method to prevent obesity following craniopharyngioma resection.INTERPRETATION There is a need for further study in this area to inform clinical and research practice; recommendations are given.Paediatric acquired brain injury (ABI) consists predominantly of traumatic brain injury (TBI) and brain tumours. In 2013 to 2014, there were 13 266 admissions for TBI and 5595 admissions for malignant neoplasms of the brain for patients under 18 years of age in UK hospitals. 1 There are a range of physical and neuropsychological sequelae following ABI associated with lasting impact on quality of life and survival.2 One such consequence is on appetite and weight, with the latter being frequently gained or lost significantly as a result of ABI and/or interventions.2 In addition to correlation with mortality, obesity and low body weight are associated with type 2 diabetes mellitus, cardiovascular disease, hypertension, and an increased risk of chronic respiratory diseases.3 Impaired stamina is a wellrecognized feature post-ABI, with disordered appetite and inadequate nutrition compounding this effect. 4 Children with ABI face greater risk of developing obesity than the general population.2 In one study investigating adverse effects in survivors following childhood low grade glioma, cumulative incidence of being overweight (body mass index [BMI] <30 but ≥25) or obese (BMI ≥30) at 5, 10, and 15 years was 18%, 35%, and 53% respectively. 5 Similarly, weight gain in children during the first year following TBI was demonstrated to be 'rapid and excessive', with males being at a higher risk of excessive weight gain than females. 6 The majority of studies investigating the impact of childhood cancer on weight focus on advanced lymphoma and leukaemia. There is a paucity of research concerning weight change in relation to paediatric brain tumours. 7This is of particular concern, because the presence of 'undernutrition' in paediatric patients with brain tumours has been associated with poorer outcomes, with underweight and undernourished children being more likely to abandon therapy and experience lower rates of event-free survival than adequately nourished children. 8While there are National Institute for Health and Care Excellence (NICE) guidelines for lifestyle weight management and services for young people who are overwei...

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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

Abstract: In children with high-risk malignancies, MA resulted in significant increases in mean percent weight change compared to placebo. Further studies of MA should be pursued to better delineate the effect on nutritional status.

Cited by 48 publications

References 32 publications

Weight Loss Correlates with Macrophage Inhibitory Cytokine-1 Expression and Might Influence Outcome in Patients with Advanced Esophageal Squamous Cell Carcinoma

Weight Loss Correlates with Macrophage Inhibitory Cytokine-1 Expression and Might Influence Outcome in Patients with Advanced Esophageal Squamous Cell Carcinoma

Nutrition in Pediatric Oncology Patients: A Systematic Review

Interventions for managing weight change following paediatric acquired brain injury: a systematic review

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