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Efficacy of Megestrol Acetate (Megace) in the Treatment of Patients With Early Endometrial Adenocarcinoma: Our Experiences With 21 Patients
  1. Zahra Eftekhar, MD*,
  2. Narges Izadi-Mood, MD,
  3. Fariba Yarandi, MD*,
  4. Hadi Shojaei, MD*,
  5. Zahra Rezaei, MD and
  6. Saeedeh Mohagheghi, MD
  1. * Departments of Gynecological Oncology,
  2. Pathology, and
  3. Gynecology & Obstetrics, Medicine School, Medical Sciences/University of Tehran, Iran.
  1. Address correspondence and reprint requests to Zahra Eftekhar, MD, Department of Gynecological Oncology, Mirza-Koochak-Khan Hospital, Nejatollahi St, Karim Khan Zand Ave, Tehran, Iran. E-mail: Eftekharz{at}hotmail.com.

Abstract

Background: There are therapeutic dilemmas regarding fertility-preserving treatment among young women with well-differentiated endometrial carcinoma.

Materials and Methods: Twenty-one patients with stage IA well-differentiated endometrial adenocarcinoma were enrolled in a prospective study. The treatment initiated with 160 mg/d of megestrol acetate. The patients underwent dilatation and curettage and hysteroscopy after 3 months, and in cases of normal pathology, the therapy continued for another 3-month period. In patients who did not respond to treatment, the dosage of the drug was doubled (320 mg/d), and the therapy continued for another 3 months. At the second time, patients who did not respond to treatment were recommended for hysterectomy, and in patients who responded to treatment, an additional 3 months of treatment with megestrol acetate (320 mg/d) was administered.

Results: Our results showed a response rate of 85.71% (18 patients), and 3 patients underwent hysterectomy. The mean (SD) treatment duration was 8.85 (2.00) months (range, 6-12 months). The response to therapy was observed in 5 patients (27.78%) with a dosage of 160 mg/d, and the remaining patients with 320 mg/d. Pregnancy occurred in 5 patients (27.78%). Recurrence happened in 3 (16.67%) of 18 patients who responded to treatment who did not give a permit to undergo hysterectomy and received medication again. Two (66.67%) of these patients experienced remission again, whereas the other one was candidate for hysterectomy.

Conclusions: The results of this study show that, when an initial response is not achieved or when disease recurs, use of 320 mg/d seems to be associated with a better therapeutic response. Furthermore, serious complications were not observed with this dosage.

  • Adenocarcinoma
  • Endometrium
  • Well-differentiated
  • Megestrol acetate

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