The effect of cyproheptadine hydrochloride (periactin) and megestrol acetate (megace) on weight in children with cancer/treatment-related cachexia.
The effect of cyproheptadine hydrochloride (periactin) and megestrol acetate (megace) on weight in children with cancer/treatment-related cachexia.
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DOI：
10.1097/mph.0b013e3181864a5e
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发表时间：
2008-11
期刊：
影响因子：
--
通讯作者：
Krischer JP
中科院分区：
文献类型：
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作者：
Couluris M;Mayer JL;Freyer DR;Sandler E;Xu P;Krischer JP
患有癌症的儿童经常伴有恶病质和营养不良。无法茁壮成长影响了近40%的晚期或进行性疾病的肿瘤患者。营养不良会降低生活质量，对疾病预后产生不利影响。刺激食欲和增加食物摄入量是对抗癌症相关恶病质的一种方法。盐酸赛庚啶（CH）是一种食欲刺激剂，用于治疗癌症相关恶病质儿童，以防止体重进一步下降。所有参与者开始CH，并在四周后评估反应。醋酸甲地孕酮（MA）的疗效进行了评估，在患者没有回应CH。医学评估，体重测量，前白蛋白和血清瘦素水平进行了随访。入组了70例患者。在66例可评价患者中，50例显示对CH有反应（平均体重增加2.6 kg，平均年龄别体重z评分变化0.35，p=0.001）。16例无应答者中有7例接受了MA。6例患者完成了4周的MA，5例有反应（平均体重增加2.5 kg）。CH最常见的副作用是嗜睡。1例MA患者出现低皮质醇水平和高脂血症。这项研究表明，CH是一种安全有效的方法，以促进体重增加的儿童与癌症/治疗相关的恶病质。
Children with cancer frequently have associated cachexia and malnutrition. Failure to thrive affects nearly 40% of oncology patients with advanced or progressive disease. Malnutrition can erode quality of life and adversely impact disease prognosis. Appetite stimulation and increased food intake is one approach to combat cancer-related cachexia. Cyproheptadine hydrochloride (CH), an appetite stimulant, was administered to children with cancer-associated cachexia to prevent further weight loss. All participants started CH and were evaluated for response after four weeks. Efficacy of megestrol acetate (MA) was evaluated in patients who did not respond to CH. Medical evaluation, weight measurements, prealbumin and serum leptin levels were preformed at follow-up visits. Seventy patients were enrolled. Of the 66 evaluable patients, 50 demonstrated a response to CH (average weight gain 2.6kg and mean weight-for-age z-score change of 0.35, p=0.001). Seven of the 16 non-responders received MA. Six patients completed four weeks of MA, 5 responded (average weight gain of 2.5kg). The most commonly reported side effect of CH was drowsiness. One patient on MA developed low cortisol levels and hyperlipidemia. This study demonstrates that CH is a safe and effective way to promote weight gain in children with cancer/treatment-related cachexia.