Management of anorexic patients in radiotherapy: A prospective randomized comparison of megestrol and prednisolone

Megestrol acetate and corticosteroid have been demonstrated to be effective in the treatment of anorexia in patients with advanced cancer. The purpose of this preliminary study is to evaluate the role of megestrol acetate and prednisolone in the treatment of anorexia induced during whole pelvis external irradiation. Fifty-two patients were randomized in this prospective study to either receive megestrol acetate (40 mg orally four times a day), prednisolone (10 mg orally three times a day), or placebo (1 tablet orally three times a day) for 21 consecutive days. Body weight, appetite, performance status, sense of well-being, and complications were assessed every 3 days. Both the megestrol acetate group and the prednisolone group showed improvement in body weight gain, appetite, performance status, and sense of well-being. Appetite improvement was statistically significant in the megestrol acetate group (P = 0.024) when compared with the placebo group. There were no complications during the 21-day trial.