Megestrol acetate plus metformin for fertility-sparing treatment of atypical endometrial hyperplasia and early-stage endometrial adenocarcinoma: a prospective study

Objective To evaluate the efficacy of medroxyprogesterone acetate(MA)plus metformin as the primary fertility-sparing treatment for atypical endometrial hyperplasia(AEH)and early-stage grade 1 endometrial adenocarcinoma(G1 EAC)and the recurrence rate after treatment.Methods Sixty patients(aged 20-42 years)with AEH and/or grade 1 EAC limited to the endometrium were enrolled prospectively and randomized into two groups(n=30)to receive oral MA treatment at the daily dose of 160 mg(control)or MA plus oral metformin(850 mg,twice a day)for at least 6 months.The treatment could extend to 12 months until a complete response(CR)was achieved,and follow-up hysteroscopy and curettage were performed every 3 months.For all the patients who achieved CR,endometrial expressions of IGFBP-rP1,p-Akt and p-AMPK were detected immunohistochemically.Results A total of 58 patients completed the treatment.After 9 months of treatment,23(76.7%)patients in the combined treatment group and 20(71.4%)in the control group achieved CR;two patients in the control group achieved CR after converting to the combined treatment.The recurrence rate did not differ significantly between the control group and combined treatment group(30.0%vs 22.7%,P>0.05).Ten(35.7%)patients in the control group experienced significant weight gain of 5.7±6.1 kg,while none of the patients receiving the combined treatment exhibited significant body weight changes.Compared with the control group,the patients receiving the combined treatment showed enhanced endometrial expressions of IGFBP-rP1 and p-AMPK with lowered p-Akt expression.Conclusion Metformin combined with MA may provide an effective option for fertility-sparing treatment of AEH and grade 1 stage IA EAC,and the clinical benefits of metformin for controlling MA-induced weight gain and promoting endometrial expressions of IGFBP-rP1 and p-AMPK while inhibiting p-Akt expression warrants further study.

Study on the Clinical Efficacy of Megestrol Acetate Dispersible Tablets in Adjuvant Treatment of Acute Leukemia

Objective:To analyze the clinical efficacy of megestrol acetate dispersible tablets in the adjuvant treatment of acute leukemia.Methods:80 patients with acute leukemia admitted from December 2021 to December 2022 were randomly divided into two groups.The control group underwent chemotherapy,and the observation group took megestrol acetate dispersible tablets and underwent chemotherapy.The effect of the treatments were evaluated by analyzing the albumin(Alb)and prealbumin(Palb)indicators,and the adverse reactions were observed.Results:There was no significant difference in Alb and Palb indexes between the two groups before treatment(P>0.05).After treatment,Alb and Palb indexes in the observation group were greater than those in the control group(P<0.05).The incidence of adverse reactions in the control group was 20.00%,which was significantly higher than the observation group(5.00%),with P<0.05.Conclusion:The combination of megestrol acetate dispersible tablets and chemotherapy is more effective in treating patients with acute leukemia,and the Alb and Palb indexes can be optimized.Besides,there are fewer adverse reactions,which means that the treatment is relatively safe.

Clinical Study on Treatment of Advanced Non-small Cell Lung Cancer by Arsenious Acid Combined with Tα-1 Thymus Peptide and Megestrol Acetate

Objective: To observe the therape utic effect of arsenious acid combined with Tα-1 thymus peptide and megestro l acetate on advanced non-small cell lung cancer.Methods: Nintey-two patients were divided randomly into the tr eated group( n =45) and the control group( n =47). The treated group were tr eated with arsenious acid combined with Tα-1 thymus peptide and megestrol ac etate, and the control group were treated with chemotherapy in the NP protocol .Results: (1) Therapeutic effect :In the 36 patients of the treated group, 2 were evaluated as CR, 8 as PR, 9 as MR, 8 as SD and 9 as PD, the CR+PR rate being 27.7% (10/36), while in the 40 patients of the control group, the co rresponding numbers were 3, 10, 11, 9, 7 and 32.5% (13/40). Comparison between t he CR+PR rate between the two groups showed insignificant difference ( P >0.05 ). (2)Clinical benefit rate: The positive rate of Karnofsky scores in the treate d group and the control group was 44.4% and 20.0% respectively; and the positive rate of body weight in the two groups was 33.3% and 12.5% respectively, the dif ference between the two groups was significant ( all P <0.05). (3)Changes of T- cell subsets and NK cell activity: CD4 and CD4/CD8 ratio after treatment i n the treated group increased significantly ( P <0.05), while in the control group, CD3, CD4, CD4/CD8 ratio and NK cell activity all lowered significantly ( P <0.01). Comparison between the two groups after treatment showed significa nt difference in CD4, CD4/CD8 ratio and NK cell activity, with those in the trea ted group all higher than those in the control group ( P <0.01). (4)Adeverse -reaction: No serious adverse reaction was found in both two groups. (5)Media n survival period:The treated group was 30 weeks and that in the control group w as 28.5 weeks, and the difference between the two groups was insignificant ( P >0.05).Conclusion: Arsenious acid combined with Tα-1 thymus peptide and megestrol acetate was a relatively effective scheme with low toxicity in tre ating advanced NSCLC.