Background: Till today the real benefit of palliative treatments in cancer cachexia is not well defined. In our trial subjective well-being (WB) and weight gain (WG) or improve of appetite (AP) and astenia (AS) in patients with cancer cachexia treated with progestins was investigated.
Methods: All the patients with advanced, hormone-resistant neoplasm, and cancer cachexia were considered eligible and enrolled into the trial. All the patients were treated with oral medroxyprogesterone acetate 1000 mg/day, and evaluated every 21 days. Subjective WB, AP and AS were evaluated using a Visual Analogique Scale (VAS); all the patients with an improve greater or equal that 20% of the VAS were considered responders, all the patients with a worsening of the VAS were considered not-responders, and all the remaining ones were considered stable. A correlation between WB and AP, AS orWG was investigated using the Spearman not-parametric test, and the relationship between the WB and the AP, AS and WG responders was investigated using the Fisher e exact test.
Results: 23 patients were enrolled into the trial. Basal mean values ( +/- standard -error) of WB, AS, AP and weight were respectively 50 mm +/- 5 mm, 70 mm +/- 5 mm, 30 mm +/- 5 mm, 54.4 kg +/- 1.8 kg. Mean WG was 1.6 kg (95% Confidence Interval: 0.9 kg-2.3 kg). 13 (56.5%), 9 (39.1%) and 18 (78.3%) patients were considered responders respectively in WB, AS and AP. No correlations were observed between WB and WG (R= - 0.1, p= 0.6), improve in AS (R= - 0.2, p = 0.3) or in AP (R = 0.05, p = 0.7), and between the WB responders and the responders in AP, AS and weight evaluations (p = 0.6, p = 0.59 and p = 0.63 respectively).
Conclusions. Our data seem to confirm the activity of medroxyprogesterone acetate in the palliative treatment of cancer cachexia, although the well known benefit in AP and WG seems to be not-related with subjective wellbeing of the patient. (supported by IOR).