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document
Intramuscular depot medroxyprogesterone versus oral megestrol for the control of postmenopausal hot flashes in breast cancer patients : a randomized study . BACKGROUND Hot flashes are frequent in postmenopausal breast cancer patients , especially when treated with tamoxifen . Estrogen replacement therapy is the most effective treatment for hot flashes , but its use is controversial in breast cancer survivors . Progestins may offer a good alternative for the control of hot flashes in this setting ; in particular , oral megestrol acetate has been proven effective in a randomized , placebo-controlled clinical trial . With the aim of further improving these results , we have designed a randomized study comparing oral megestrol acetate with depot intramuscular ( i.m . ) medroxyprogesterone acetate ( MPA ) for the control of hot flashes in postmenopausal patients with a history of breast cancer . PATIENTS AND METHODS Seventy-one postmenopausal patients were randomized to receive an i.m . injection of depot MPA 500 mg on days 1 , 14 and 28 , or oral megestrol acetate 40 mg daily for 6 weeks . Patients recorded daily the number and severity of their hot flashes ; response was defined as a > or =50 % decrease in the number and severity of hot flashes . RESULTS At week 6 , hot flashes were reduced by 86 % on average in the whole group of patients , without significant differences between the two progestins . Response was obtained by 75 and 67 % of patients receiving MPA or megestrol , respectively ( P = 0.5 ) . Responders were followed to assess maintenance of response ( without further treatment ) , which was significantly better with i.m . MPA : in this group , 89 % of responders still showed a benefit at week 24 , compared with 45 % in the megestrol group ( P = 0.03 ) . CONCLUSIONS Our study shows that a short cycle of i.m . depot MPA injections provides significant and long-lasting relief from postmenopausal hot flashes in patients with a history of breast cancer , offering an alternative to estrogen replacement therapy or prolonged administration of oral megestrol .
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Intervention_Pharmacological
medroxyprogesterone
9938
Intervention_Pharmacological
megestrol
9939
Intervention_Pharmacological
Estrogen replacement therapy
9940
Intervention_Pharmacological
megestrol acetate
9941
Intervention_Pharmacological
medroxyprogesterone acetate ( MPA )
9942
Intervention_Pharmacological
depot MPA
9943
Intervention_Pharmacological
oral megestrol acetate
9944
Intervention_Pharmacological
MPA
9945
Intervention_Pharmacological
megestrol
9946
Intervention_Pharmacological
MPA
9947
Intervention_Pharmacological
megestrol
9948
Outcome_Physical
hot flashes
9949
Outcome_Physical
Hot flashes
9950
Outcome_Physical
hot flashes
9951
Outcome_Physical
hot flashes
9952
Outcome_Physical
hot flashes
9953
Outcome_Physical
hot flashes
9954
Outcome_Physical
hot flashes
9955
Outcome_Other
relief
9956
Outcome_Physical
postmenopausal hot flashes
9957
Participant_Condition
breast cancer patients :
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Participant_Condition
postmenopausal breast cancer patients