The purpose of this study was to investigate the use of naproxen in patients with paraneoplastic fever. In total, 82 patients were entered in this trial. Tumours diagnosed histologically were: breast 12, testes 2, colorectal 16, lung 15, head and neck 13, renal 6, unknown origin 8, pancreas 3, ovarian 2, cervix uteri 2, gastric 3, melanomas 2 and sarcomas 2. A clinical methodology was followed in order to exclude any possibility of infection. After 5 days of persistent unexplained fever 38deg;C without any incidence of infection and despite adequate antibiotic treatment, the fever was attributed to the malignancy and patients were treated with oral naproxen 250mg twice a day at 12-hourly intervals. Fever was monitored for 10 days after initiation of treatment with naproxen. Of the 82 patients who received this drug, 18 patients (22percnt;) did not respond to therapy. We then re-evaluated those 18 patients for the possibility of infection: 6 were found to suffer from microbial infections, and 8 received new empiric antibiotic treatment; of these 8, 4 responded. Among the remaining 4 nonresponders, one was found to have a rectal abscess, and the other 3 died shortly afterwards; we were thus unable to follow them up completely. We therefore concluded that the use of nonsteroidal anti-inflammatory drugs, particularly naproxen, in the treatment of paraneoplastic fever is successful in 78percnt; of patients. The persistence of fever in patients who received naproxen might be attributed to an infectious cause.
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