In Vivo. 2010
Synchronization of cortisol
circadian rhythm by the pineal hormone melatonin in untreatable
metastatic solid tumor patients and its possible prognostic significance
on tumor progression.
Fede G, Rovelli
Surgical Division, Bassini Hospital, Cinisello
Balsamo, Milan, Italy.
BACKGROUND: Cancer progression
has been associated with neuroendocrine alterations involved in the
control of the circadian rhythms, particularly those of cortisol.
Moreover, the evidence of an altered cortisol rhythm may predict a poor
prognosis in cancer patients. Finally, cancer progression has been
proven to be associated with alterations in the pineal gland, which
plays a fundamental role in the control of circadian biological rhythms.
On this basis, a study was planned to evaluate the effects of a chronic
treatment with the pineal hormone melatonin (MLT) in advanced cancer
patients with altered cortisol circadian rhythm.
PATIENTS AND METHODS:
The study included 14 untreatable metastatic cancer patients showing
alterations of cortisol rhythm. They were treated by MLT at 20 mg/day
orally, in the evening, for 3 consecutive months. RESULTS: a
normalization of cortisol rhythm was achieved in 4/14 (29%) patients.
Moreover, stable disease (SD) was obtained in 6/14 (43%) patients under
MLT therapy, whereas the other 8 patients had progressive disease (PD).
Finally, the percentage of cortisol rhythm normalization achieved in
patients with SD was significantly higher than that observed in patients
CONCLUSION: These results show that MLT may normalize cortisol
rhythm in advanced cancer patients and this effect appears to be
associated with SD, thus confirming the negative prognostic significance
of cortisol rhythm alterations in cancer.