Conservative therapy with metformin plus megestrol acetate for endometrial atypical hyperplasia / 부인종양

OBJECTIVE: To compare the efficacy of metformin plus megestrol acetate (MA) with that of MA alone for treating endometrial atypical hyperplasia (EAH). METHODS: This pilot study included 16 EAH patients who met at least one metabolic syndrome (MS) criterion and received either adjunctive metformin plus MA (MET group) or MA monotherapy (MA group). Each patient in the MA group received 160 mg of MA daily, whereas patients in the MET group received the same dose of MA plus 0.5 g of metformin thrice daily. Treatment response was assessed by histological examination of dilation and curettage specimens obtained after 12 weeks of therapy. RESULTS: Each group had eight patients, and half of the patients in each group were diagnosed with MS. The complete response (CR) rate was 75% (6/8) in the MET group and 25% (2/8) in the MA group (p=0.105). Complications of MS did not affect the response rates in either group. In the MET group, 75% (3/4) of the patients had CR in the presence or absence of MS. In the MA group, 50% (2/4) of the patients with MS had CR, whereas no patient without MS had CR. No irreversible toxicities were observed. CONCLUSION: Metformin plus MA may be a potential alternative therapy for treating EAH, and the MS status of patients may have no effect on the efficacy of metformin plus MA therapy.

Conservative treatment for atypical endometrial hyperplasia: what is the most effective therapeutic method? / 부인종양

No abstract available.

Safety of Megestrol Acetate in Palliating Anorexia-Cachexia Syndrome in Patients with Castration-Resistant Prostate Cancer

There are concerns whether megestrol acetate (MA) stimulates the growth of prostate cancer in castration-resistant prostate cancer (CRPC). We evaluated the effect of cumulative doses of MA on the disease-specific survival (DSS) in patients with CRPC who were receiving Docetaxel-based chemotherapy. From July 2003 through June 2009, we identified 109 consecutive patients with CRPC and who had received docetaxel-based chemotherapy. Of these patients, 68 (62.4%) have not received MA, whereas 21 patients (19.3%) and 20 patients (18.3%) had received low dose MA (total 18,400 mg), respectively. We assessed the effect of several variables on DSS. None of the clinicopathological variables differed among the three groups. When comparing DSS using Kaplan-Meier analysis, there was no statistically significant survival differences among the three groups (P = 0.546). Using multivariate Cox proportional analyses with backward elimination, the number of docetaxel cycles was only significant factor predicting DSS (HR: 0.578, 95% CI: 0.318-0.923, P = 0.016). Cumulative doses of MA as adjuvant treatment for patients with CRPC and who are receiving docetaxel-based chemotherapy, did not affect their DSS. Therefore, MA can be safely administered in cachexic patients with CRPC.

Estudo de fase II de acetato de megestrol em anorexia e perda de peso em pacientes com AIDS / Phase II trial of megestrol acetate in patients with Aids-related anorexia and weight loss

Objetivos: Avaliar o efeito da suspensäo oral de acetato de megestrol na alteraçäo de peso corpóreo, na diminuiçäo da anorexia e na melhora da qualidade de vida de pacientes com AIDS. Desenho do Estudo: Estudo aberto, com 600 mg de acetato de megestrol em suspensäo oral, por dia, por 12 semanas. Pacientes: Foram envolvidos no estudo 20 pacientes soropositivos para HIV, estando na faixa de 30 porcento de seu peso ideal e que perderam mais de 10 por cento de seu peso corpóreo inicial desde o diagnóstico da infecçäo por HIV. Resultados: Foram avaliados 20 pacientes soropositivos para HIV, sendo 8 (40 por cento) do sexo feminino, 12 (60 por cento) do sexo masculino, com idade média de 33,7 anos, recebendo 600mg/dia de acetato de megestrol. Antes do uso da medicaçäo do estudo, os pacientes apresentavam peso médio de 55,3 Kg e após o uso da mesma este valor passou a 62,8 Kg com ganho percentual de 13,6 porcento. Conclusöes: A ingestäo do medicamento acetato de megestrol teve grande importância na melhora do estado nutricional dos pacientes, uma vez que a maioria apresentou aumento de apetite e conseqüente aumento de peso sem apresentar intercorrências que pudessem interferir no diagnóstico do seu estado nutricional.

Cáncer de mama metastásico al nervio óptico / Methastasic mama cancer a the optic nerve

Se presenta el caso de una paciente femenina de 50 años de edad con diagnóstico de carcinoma de mama derecha de 7 años de evolución, con clínica de dolor óseo generalizado y disminución de la agudeza visual bilateral. Los estudios de extensión revelaron un estadio IV con enfermedad metastásica en hueso, hígado y bilateral al nervio óptico. Recibió tratamiento multidisciplinario con radioterapia paliativa a ambas órbitas, encéfalo, zonas dolorosas óseas y en huesos de sostén, se añadió hormonoterapia con Acetato de megestrol, tamoxifén y dexametasona. Se obtuvo una respuesta parcial satisfactoria con incremento de la agudeza visual y disminución del dolor óseo. El tratamiento paliativo de los pacientes con enfermedad avanzada, permite obtener respuestas subjetivas importantes, al mejorar la sintomatología logramos que el paciente se integre a su entorno familiar y social elevando su calidad de vida, cumplimos así con uno de los preceptos de la medicina "aliviar el dolor", comprender el sufrimiento y aumentar la esperanza en la vida