Abstract：
OBJECTIVE: Megestrol acetate (MA) is used to manage anorexia and cachexia in patients with advanced cancer. This study investigated the prescription patterns of MA in patients with metastatic gastric cancer, as well as evaluated its impact on survival outcomes and the incidence of venous thromboembolism (VTE).
METHODS: A Health Insurance Review and Assessment (HIRA) service database was used to investigate differences in baseline characteristics, survival, and the incidence of VTE according to MA prescription patterns (i.e., prescription vs. no prescription) in patients diagnosed with metastatic gastric cancer from July 2014 to December 2015.
RESULTS: A total of 1938 patients were included in this study. In total, 65% of the patients were prescribed MA. Older age, treatment in tertiary hospitals, and palliative chemotherapy were statistically significant predictive factors for MA prescription. Continuous prescription of MA was observed in 37% of patients. There was no statistically significant difference in survival between the MA and non-MA prescription groups on multivariate analysis. Among the 1427 patients included in the analysis for VTE incidence, 4.3% and 2.9% were diagnosed with VTE during the follow-up period in the MA and non-MA prescription groups, respectively. However, there was no statistically significant difference in VTE diagnosis between the groups on multivariate analysis.
CONCLUSIONS: MA is commonly prescribed for metastatic gastric cancer, especially in elderly patients and those undergoing palliative chemotherapy, without significantly affecting survival or VTE risk.
METHODS: A Health Insurance Review and Assessment (HIRA) service database was used to investigate differences in baseline characteristics, survival, and the incidence of VTE according to MA prescription patterns (i.e., prescription vs. no prescription) in patients diagnosed with metastatic gastric cancer from July 2014 to December 2015.
RESULTS: A total of 1938 patients were included in this study. In total, 65% of the patients were prescribed MA. Older age, treatment in tertiary hospitals, and palliative chemotherapy were statistically significant predictive factors for MA prescription. Continuous prescription of MA was observed in 37% of patients. There was no statistically significant difference in survival between the MA and non-MA prescription groups on multivariate analysis. Among the 1427 patients included in the analysis for VTE incidence, 4.3% and 2.9% were diagnosed with VTE during the follow-up period in the MA and non-MA prescription groups, respectively. However, there was no statistically significant difference in VTE diagnosis between the groups on multivariate analysis.
CONCLUSIONS: MA is commonly prescribed for metastatic gastric cancer, especially in elderly patients and those undergoing palliative chemotherapy, without significantly affecting survival or VTE risk.
摘要：
目的：醋酸甲地孕酮（MA）用于治疗晚期癌症患者的厌食和恶病质。这项研究调查了转移性胃癌患者MA的处方模式，以及评估其对生存结局和静脉血栓栓塞（VTE）发生率的影响。
方法：使用健康保险审查和评估（HIRA）服务数据库来调查基线特征的差异，生存,以及根据MA处方模式的VTE发生率(即，处方vs.2014年7月至2015年12月诊断为转移性胃癌的患者没有处方）。
结果：本研究共纳入1938例患者。总的来说,65%的患者被处方为MA。年纪大了,在三级医院治疗，和姑息性化疗是MA处方的有统计学意义的预测因素。在37％的患者中观察到MA的连续处方。在多变量分析中，MA和非MA处方组之间的生存率没有统计学上的显着差异。在纳入VTE发病率分析的1427例患者中，在MA和非MA处方组中，在随访期间诊断为VTE的分别为4.3％和2.9％，分别。然而,在多因素分析中,两组间VTE诊断差异无统计学意义.
结论：MA通常用于转移性胃癌，尤其是老年患者和接受姑息化疗的患者，而不会显著影响生存率或VTE风险。
方法：使用健康保险审查和评估（HIRA）服务数据库来调查基线特征的差异，生存,以及根据MA处方模式的VTE发生率(即，处方vs.2014年7月至2015年12月诊断为转移性胃癌的患者没有处方）。
结果：本研究共纳入1938例患者。总的来说,65%的患者被处方为MA。年纪大了,在三级医院治疗，和姑息性化疗是MA处方的有统计学意义的预测因素。在37％的患者中观察到MA的连续处方。在多变量分析中，MA和非MA处方组之间的生存率没有统计学上的显着差异。在纳入VTE发病率分析的1427例患者中，在MA和非MA处方组中，在随访期间诊断为VTE的分别为4.3％和2.9％，分别。然而,在多因素分析中,两组间VTE诊断差异无统计学意义.
结论：MA通常用于转移性胃癌，尤其是老年患者和接受姑息化疗的患者，而不会显著影响生存率或VTE风险。
