Objective To detect the increase in skeletal muscle mass after oral megestrol administration and its influence on the levels of four cytokines, analyze the relationship between cytokine expression and sarcopenia, and provide new insights for the management, curative effect prediction, and early screening of lung cancer patients with sarcopenia.

Methods  A total of 60 patients with lung cancer complicated by sarcopenia were recruited from The Central Hospital of Shaoyang between June 2023 and June 2024. They were randomly assigned into an experimental group (30 cases) and a control group (30 cases). Patient data, including age, sex, body mass index, skeletal muscle mass index (SMI), blood glucose, serum albumin, triglyceride levels, and the levels of four cytokines (IL-1β, IL-6, IFN-γ, and TNF-α), were recorded. The correlation between the four cytokines and sarcopenia was investigated after the intervention.

Results There was no significant difference between the experimental and control groups except for the IL-1β level (P>0.05). The levels of the four cytokines decreased significantly on the 10th day of medication compared to days 10–25 (P<0.05). A positive correlation between the levels of the four cytokines at different time points (P<0.05) was observed. After megestrol intervention, SMI values increased by 11.8% from the baseline.

Conclusions Oral administration of megestrol can reduce the levels of cytokines IL-1β, IL-6, IFN-γ, and TNF-α while increasing the skeletal muscle mass to a certain extent. This suggests that megestrol may have positive therapeutic value in improving the prognosis and related clinical symptoms of patients with lung cancer and sarcopenia.