Short-term outcomes of low-dose megestrol acetate on appetite and caregiver distress in advanced head and neck cancer: A prospective single-arm study.

BACKGROUND

Cancer-associated anorexia is common in patients with locally advanced head and neck cancer undergoing radiotherapy and contributes to nutritional decline, reduced treatment tolerance, and psychosocial distress. While megestrol acetate (MA) has been shown to improve appetite in various cancer populations, limited data exist on its impact on caregiver-related outcomes. This study evaluated the short-term effect of low-dose MA on patients' appetite and caregivers' eating-related distress.

METHODS

This prospective, single-arm observational study included 50 adult patients with histologically confirmed locally advanced head and neck squamous cell carcinoma experiencing treatment-related anorexia. Patients received oral MA 160 mg during radiotherapy for 10 days. Appetite was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ; range 4-20), and caregiver distress was evaluated using the Eating Distress Scale (EDS). Baseline and 10-day follow-up scores were compared using paired statistical tests.

RESULTS

Mean SNAQ score increased significantly from 9.76 ± 1.59 at baseline to 14.32 ± 1.47 at follow-up [mean difference 4.56; 95% confidence interval (CI) 3.97-5.14; P = 0.001]. EDS scores decreased significantly from 30.32 ± 2.31 to 18.28 ± 4.59 (mean reduction 12.04; 95% CI 10.77-13.30; P = 0.001). Appetite improvement was observed despite advanced disease stage and compromised performance status.

CONCLUSIONS

Low-dose MA was associated with significant improvement in appetite and reduction in caregiver eating-related distress over a 10-day follow-up period. These findings suggest short-term symptomatic benefit and support the inclusion of caregiver-centered outcomes in supportive oncology research. Larger controlled studies with longer follow-up are warranted to validate these observations.