I have just revived my 4 years old hack that adds MSVC support to ccache. The use case is a bit limited - you have to use it from inside cygwin; but that is exactly what LibreOffice needs :-) So I have updated LibreOffice's configure.in to be able to handle it well - so far in the libreoffice-3-4 branch, but it will get to master the next time we merge the branch there.
How to use it? Download the ccache.exe binary, put it to eg. your ~/bin (or somewhere else in your PATH), setup the CC and CXX environment variables, and compile as you are used to (./autogen.sh, make, ...), like:
CC="ccache C:/PROGRA~1/MICROS~1.0/VC/bin/cl.exe" CXX="ccache C:/PROGRA~1/MICROS~1.0/VC/bin/cl.exe" ./autogen.sh make
And yes, it would be great to do the ccache support as simple as a --enable-ccache configure option - but I did not find time to fine tune it on the other platforms, so I'll go for that only when I find there is a demand for that - drop me a mail ;-)
If you want to have a look at the ccache's statistics, run ccache -s. I've done no measurement how much time it saves overall - if are able to do any, please mail me your results too.