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目的:观察甲孕酮治疗癌症恶病质效果,并对其机理作初步探讨。方法:将我院1997年1月～1999年4月入院晚期癌症患者随机分为两组:第1组30例第1周期接受化疗及甲孕酮治疗,第2周期单独化疗;第2组30例2周期均单独进行化疗。检测两组患者血清中肿瘤坏死因子(TNF-α)含量,并观察比较患者食欲,体重及骨髓抑制情况。结果:甲孕酮治疗组可使18/30(60%)患者改善食欲,16/30(53.3%)患者体重增加,与对照组比较有统计学意义(P<0.05),两组间血清中TNF-α含量比较无统计学差异(P>0.05)。结论:甲孕酮可明显改善晚期癌症患者的食欲及体重。但甲孕酮未见明显骨髓保护作用,无降低晚期癌症患者血清中TNF-α浓度作用。
Objective: To observe the effect of megestrol in the treatment of cancer cachexia, and to explore its mechanism. Methods: Patients with advanced cancer admitted to our hospital from January 1997 to April 1999 were randomly divided into two groups: group 1, 30 patients received chemotherapy and medroxyprogesterone acetate in the first cycle, and chemotherapy in the second cycle; group 30 Example 2 cycles were chemotherapy alone. Tumor necrosis factor (TNF-α) levels were measured in two groups of patients, and the appetite, body weight and bone marrow suppression were compared. Results: The medroxyprogesterone treatment group improved the appetite in 18/30 (60%) patients and the weight gain in 16/30 (53.3%) patients, which was statistically significant compared with the control group (P <0.05) There was no significant difference in TNF-αcontent (P> 0.05). Conclusion: Medroxyprogesterone acetate can significantly improve the appetite and weight of patients with advanced cancer. Medroxyprogesterone did not show significant myeloprotective effect and did not reduce the serum concentration of TNF-α in advanced cancer patients.