Oesophageal cancer and cachexia: the effect of short-term treatment with thalidomide on weight loss and lean body mass.
BACKGROUND
Cachexia is common in patients with advanced cancer and has a direct impact on well-being and mortality.


OBJECTIVE
To test the hypothesis that thalidomide can promote weight gain and lean body mass in patients with advanced oesophageal cancer.


METHODS
In an open-label study, 11 patients with non-obstructing and inoperable oesophageal cancer were established on an isocaloric diet for 2 weeks, followed by 2 weeks on thalidomide, 200 mg daily. The primary end-points were weight change and lean body mass. Secondary end-points were quality of life and changes in resting energy expenditure.


RESULTS
Ten patients completed the study protocol. The average caloric intake remained the same throughout the study period in all patients. Nine of 10 patients (95% confidence interval, 0.60, 0.98) lost weight on diet alone. The mean weight gain on thalidomide in the following 2 weeks was 1.29 kg (median, 1.25 kg). A similar trend was shown in the lean body mass. Eight of nine patients (95% confidence interval, 0.57, 0.98) initially lost lean body mass on diet alone (missing data in one patient). The mean gain in lean body mass on thalidomide in the following 2 weeks was 1.75 kg (median, 1.33 kg).


CONCLUSIONS
Thalidomide treatment appeared to reverse the loss of weight and lean body mass over the 2-week trial period.
Khan
Z H
ZH
Department of Gastroenterology and Research and Developent, Derby City Hospital, NHS Trust, UK. khanz@est.nhs.uk
Simpson
E J
EJ
Cole
A T
AT
Holt
M
M
MacDonald
I
I
Pye
D
D
Austin
A
A
Freeman
J G
JG
D000368:Aged; D000369:Aged, 80 and over; D001481:Basal Metabolism; D001823:Body Composition; D015992:Body Mass Index; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology; D002149:Energy Intake; D004938:Esophageal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013792:Thalidomide / Q000008:administration & dosage*; D014508:Urea / Q000652:urine; D015431:Weight Loss
D013792:Thalidomide; D014508:Urea