Does perioperative oxandrolone improve nutritional status in patients with cachexia related to head and neck carcinoma?
Bottom Line: Perioperative administration of oxandrolone resulted in objective improvements in prealbumin levels and subjective improvements in surgical wounds. Oxandrolone administered 10 mg twice daily (BID) for 10 days may be a useful adjunct in the perioperative care of nutritionally deficient HNC patients who are at risk for or have demonstrated impaired wound healing.
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June 2019Background: Cancer cachexia affects up to more than 50% of patients with advanced head and neck cancer (HNC). To date, the potential utility of anabolic steroids in perioperative cachectic HNC patients has not been determined.
Study design: Retrospective review of pre- and post-oxandrolone administration prealbumin levels in 18 perioperative HNC patients between October 2007 and October 2014.
Setting: Department of Otorhinolaryngology–Head and Neck Surgery, University of Oklahoma, Oklahoma City.
Synopsis: Eighteen patients were identified who met inclusion criteria. The patients ranged in age from 44 to 75 years with an average age of 63.4 years; 11 (61%) were men and seven (39%) were women. Patients received oxandrolone for an average of 22.8 days (range: 7–45 days). The majority of patients (15/18) received 10 mg per os (PO) BID, with one patient receiving 5 mg PO BID, another 2.5 mg PO four times daily (QID), and the third 10 mg PO three times a day. All 18 patients demonstrated an overall improvement in prealbumin levels during the course of their treatment. The degree of improvement and the time over which this occurred, however, varied by patient. The earliest response to therapy was seen after four days; 50% showed improvement by day 8, 70% by day 10, and 100% by day 18. Concurrent subjective improvement in wound healing was also observed, as documented by the evaluating surgeon.
Citation: Laryngoscope Inv Otolaryngol. May 15, 2019. DOI: 10.1002/lio2.268.