Octreotide in relieving gastrointestinal symptoms due to bowel obstruction

Mercadante, Sebastiano; Spoldi, E.; Caraceni, Augusto; Maddaloni, Salvatore; Simonetti, Maria Teresa

doi:10.1177/026921639300700406

Cited by 116 publications

(51 citation statements)

References 14 publications

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“…A marked reduction in nasogastric tube aspirate was noted in 2 of these patients. In our own experience and that of others this observation Dean has been consistent [32][33][34][35]. One patient of ours with inoperable bowel obstruction survived for 3 months being treated at home with subcutaneous octreotide and nightly subcutaneous fluid.…”

Section: Bowel Obstructionsupporting

confidence: 85%

The Palliative Effects of Octreotide in Cancer Patients

Dean¹

2001

Chemotherapy

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Octreotide is an extremely useful compound for palliative care physicians. It appears to be active in a number of different pain states and may be given by the spinal and intraventricular route. Its actions in reducing gut motility and secretions make it a valuable adjunct in the management of inoperable bowel obstruction. The same actions make it a potent antidiarrheal agent. Octreotide will often succeed where other antidiarrheal agents fail. Its ability to reduce gut secretions has led to its use in the treatment of fistulae. It has also been proposed as a useful drug in the management of cachexia and ascites. Most of the existing evidence is based on small numbers of case reports and further larger trials are necessary.

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Section: Bowel Obstructionsupporting

confidence: 85%

The Palliative Effects of Octreotide in Cancer Patients

Dean¹

2001

Chemotherapy

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“…OC affects gastrointestinal function by reducing gastric and intestinal secretion and bile flow by complex endocrine mechanisms. 7 The aim of this study was to systematically review the studies of the most popular drugs used in the medical management of inoperable malignant bowel obstruction in attempt to evaluate the effectiveness and provide some lines of evidence.…”

Section: Introductionmentioning

confidence: 99%

Medical Treatment for Inoperable Malignant Bowel Obstruction: A Qualitative Systematic Review

Mercadante

Casuccio

Mangione

2007

Journal of Pain and Symptom Management

Self Cite

105

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The use of symptomatic agents has greatly improved the medical treatment of advanced cancer patients with inoperable bowel obstruction. A systematic review of studies of the most popular drugs used in the medical management of inoperable malignant bowel obstruction was performed to assess the effectiveness of these treatments and provide some lines of evidence. Randomized trials that involved patients with a clinical diagnosis of intestinal obstruction due to advanced cancer treated with these drugs were reviewed. Five reports fulfilled inclusion criteria. Three studies compared octreotide (OC) and hyoscine butylbromide (HB), and two studies compared corticosteroids (CSs) and placebo. Globally, 52 patients received OC, 51 patients received HB, 37 patients received CSs, 15 patients received placebo, and 37 patients received both placebo and CSs. On the basis of these few data, the superiority of OC over HB in relieving gastrointestinal symptoms was evidenced in a total of 103 patients. The latter studies had samples more defined in terms of stage and inoperability, and had a shorter survival in comparison with studies of CSs (less than 61 days, most of them less than 20 days). Data on CSs are less convincing, due to the methodological weakness of existing studies. This review confirms the difficulties in conducting randomized controlled trials in this population. J Pain Symptom Manage 2007;33:217e223.

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“…Unfortunately, in most of these trials the further treatments of patients failing octreotide therapy were not reported. Furthermore, there are data suggesting that in the end stages of GI cancers, when bowel obstruction is present, octreotide may provide some symptomatic benefit, and may also be a determinant of survival [39].…”

Section: Months)mentioning

confidence: 99%

Gastrointestinal Cancer Refractory to Chemotherapy: A Role for Octreotide?

Cascinu¹,

Catalano²,

Giordani³

et al. 2001

Chemotherapy

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Although octreotide has been shown to inhibit the growth of gastrointestinal (GI) tumors in vitro and in vivo, preliminary clinical trials have reported disappointing results for this somatostatin analog in patients with GI cancers. The results of these trials probably reflect the difficulty in assessing the therapeutic potential of an agent such as octreotide in GI cancers. Thus, it is possible that treatment with octreotide could be useful in the stabilization of disease if it is associated with an improvement in survival. On the basis of these considerations five randomized trials were carried out to evaluate the therapeutic potential in patients with GI cancers. Four trials (one in patients with colorectal carcinoma and three in patients with carcinoma of the pancreas) did not show any advantage of octreotide in untreated patients; in contrast, one trial reported that octreotide prolonged survival in patients with GI cancers refractory to chemotherapy. Some clinical features of the latter study (treatment with chemotherapy, different schedules) may explain these conflicting results. Although data from randomized trials suggest that octreotide is not effective in untreated asymptomatic advanced GI cancer patients, further studies are warranted to assess the efficacy of octreotide in chemotherapy refractory patients in order to clarify the impact of octreotide in terms of not only survival but also on the patients’ quality of life.

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Octreotide in relieving gastrointestinal symptoms due to bowel obstruction

Cited by 116 publications

References 14 publications

The Palliative Effects of Octreotide in Cancer Patients

The Palliative Effects of Octreotide in Cancer Patients

Medical Treatment for Inoperable Malignant Bowel Obstruction: A Qualitative Systematic Review

Gastrointestinal Cancer Refractory to Chemotherapy: A Role for Octreotide?

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