012 OESOPHAGEAL CANCER AND CACHEXIA: THE EFFECTS OF THALIDOMIDE ON WEIGHT LOSS AND LEAN BODY MASS IN A SEQUENTIAL (METABOLIC) STUDY

Z.H. Khan¹, E. Simpson², A.T. Cole¹, I. Macdonald², D. Pye², A. Austin¹, J.G. Freeman¹. ¹Department of Gastroenterology, Derby City Hospital, Derby, UK; ²University Department of Physiology and Medical Physics, Queens Medical Centre, Nottingham, UK

Aim: To investigate the potential for using thalidomide as an anti-cachectic agent in patients with advanced oesophageal cancer by studying its effect on body composition and weight.

Methods: 11 patients with non-obstructing and in-operable oesophageal cancer were included in the study.

Study protocol: Patients were established on an isocaloric diet over a 10-day period. Body weight, body composition studies with DEXA scanning, REE (resting energy expenditure) and serum levels of insulin, thyroxine, catecholamines and cortisol were measured at the entry and then after two weeks on diet alone. Patients were then started on thalidomide for 2 weeks and the measurements were repeated. Quality of life (QOL) was similarly measured as a secondary end point.

Results: Ten patients completed the study protocol. The average caloric intake remained the same throughout the study period in all these patients. 9/10 (95% CI 0.60, 0.98) lost weight on diet alone. The mean gain on thalidomide in the following two weeks was 1.29 kg (median 1.25kg). A similar trend was shown in lean body mass. There were missing data for one patient, so nine were analysed. 8/9 (95% CI 0.57, 0.98) initially lost mass on diet alone. The mean gain on thalidomide in the following two weeks was 1.75 kg (median 1.33 kg). The mean change in REE was 1.75 (95% CI –0.42, 3.91) on thalidomide. Amongst hormonal assay, changes in catecholamines approached statistical significance. The mean change in catecholamines on thalidomide was −0.71 (95% CI −1.60, 0.02).

Conclusions: In this sequential study of patients …