[Standards, Options and Recommendations (SOR) for the use of appetite stimulants in oncology. Work group. Federation of the French Cancer Centres (FNCLCC)].
BACKGROUND
The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.


OBJECTIVE
To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for the use of appetite stimulants in oncology.


METHODS
Data were identified by searching Medline and the personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to 55 independent reviewers, and to the medical committees of the 20 French Cancer Centres.


RESULTS
The main recommendations for the use of appetite stimulants in oncology are: 1) Corticosteroids and the synthetic progestogens (megestrol acetate and medroxyprogesterone acetate) are appetite stimulants. 2) They can be useful in managing anorexia and weight loss in cancer patients, especially in the palliative setting, despite the potential side-effects of these agents. 3) The most effective way of using these drugs is not known. Inclusion in clinical trials is recommended. 4) Cyproheptadine, metoclopramide, nandrolone and pentoxif line should not be used outside prospective clinical trials. 5) Hydrazine sulfate should not be used.
Desport
J C
JC
FNCLCC, Opération Standards, Options, Recommandations, 101, rue de Tolbiac, 75654 Paris Cedex 13.
Blanc-Vincent
M P
MP
Gory-Delabaere
G
G
Bachmann
P
P
Béal
J
J
Benamouzig
R
R
Colomb
V
V
Kere
D
D
Melchior
J C
JC
Nitenberg
G
G
Raynard
B
B
Scheiner
S
S
Senesse
P
P
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D019167:Appetite Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008525:Medroxyprogesterone / Q000009:adverse effects / Q000627:therapeutic use; D008535:Megestrol / Q000009:adverse effects / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications; D045167:Progesterone Congeners / Q000009:adverse effects / Q000627:therapeutic use*; D012196:Review Literature as Topic
D000305:Adrenal Cortex Hormones; D019167:Appetite Stimulants; D045167:Progesterone Congeners; D008535:Megestrol; D008525:Medroxyprogesterone