Octreotide prescribing patterns in the palliation of symptomatic inoperable malignant bowel obstruction patients at a single US academic hospital

Hwang, Mei‐Yuh; Pirrello, Rosene D.; Pu, Minya; Messer, Karen; Roeland, Eric

doi:10.1007/s00520-013-1860-1

Cited by 8 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 57 observational studies 45 – 101 reported on the treatment of 12,587 patients, 92% of which were patients with malignant bowel obstruction. Of these palliative patients, 27% underwent surgery for their obstruction (initially or after temporary stenting) and 73% were inoperable.…”

Section: Resultsmentioning

confidence: 99%

The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

et al. 2022

View full text Add to dashboard Cite

Background: Malignant bowel obstruction, a complication of certain advanced cancers, causes severe symptoms which profoundly affect quality of life. Clinical management remains complex, and outcome assessment is inconsistent. Aim: To identify outcomes evaluating palliative treatment for inoperable malignant bowel obstruction, as part of a four-phase study developing a core outcome set. Design: The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); PROSPERO (ID: CRD42019150648). Eligible studies included at least one subgroup with obstruction below the ligament of Treitz undergoing palliative treatment for inoperable malignant bowel obstruction. Study quality was not assessed because the review does not evaluate efficacy. Data sources: Medline, Embase, the Cochrane Database, CINAHL, PSYCinfo Caresearch, Open Grey and BASE were searched for trials and observational studies in October 2021. Results: A total of 4769 studies were screened, 290 full texts retrieved and 80 (13,898 participants) included in a narrative synthesis; 343 outcomes were extracted verbatim and pooled into 90 unique terms across six domains: physiological, nutrition, life impact, resource use, mortality and survival. Prevalent outcomes included adverse events (78% of studies), survival (54%), symptom control (39%) and mortality (31%). Key individual symptoms assessed were vomiting (41% of studies), nausea (34%) and pain (33%); 19% of studies assessed quality of life. Conclusions: Assessment focuses on survival, complications and overall symptom control. There is a need for definitions of treatment ‘success’ that are meaningful to patients, a more consistent approach to symptom assessment, and greater consideration of how to measure wellbeing in this population.

show abstract

Section: Resultsmentioning

confidence: 99%

The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Disruption of the fluid secretion-absorption balance of the intestine is a key pathophysiological change in MBO. 16 Generally, the pathophysiology of MBO can be divided into 5 processes 18 : (1) Bowel obstruction gives rise to intestinal distension, resulting in increased intestinal secretion and malabsorption of water and electrolytes in the obstructed bowel segment. (2) Secreted intestinal fluid further accumulates, and the intestinal tract moves in an abnormally uncoordinated manner, further stimulating contraction of the intestinal lumen and greater proximal distension.…”

Section: Pathophysiologymentioning

confidence: 99%

Medical Management of Inoperable Malignant Bowel Obstruction

et al. 2020

View full text Add to dashboard Cite

Objective: To review medical management of inoperable malignant bowel obstruction. Data Sources: A literature review using PubMed and MEDLINE databases searching malignant bowel obstruction, etiology, types, pathophysiology, medical, antisecretory, anti-inflammatory, antiemetic drugs, analgesics, promotion of emptying, prevention of infection, anticholinergics, somatostatin analogs, gastric antisecretory drugs, prokinetic agents, glucocorticoid, opioid analgesics, antibiotics, enema, and adverse effects. Study Selection and Data Extraction: Randomized or observational studies, cohorts, case reports, or reviews written in English between 1983 and November 2020 were evaluated. Data Synthesis: Malignant bowel obstruction (MBO) commonly occurs in patients with advanced or recurrent malignancies and severely affects the quality of life and survival of patients. Its management remains complex and variable. Medical management is the cornerstone of MBO treatment, with the goal of reducing distressing symptoms and optimizing quality of life. Until now, there has been neither a standard clinical approach nor registered medications to treat patients with inoperable MBO. Relevance to Patient Care and Clinical Practice: This review provides information on the etiology, type and pathophysiology, and medical treatment of MBO and related adverse reactions of the drugs commonly used, which can greatly assist clinicians in making clinical decisions when treating MBO. Conclusions: Published research shows that medical management of MBO mainly consists of antisecretory, anti-inflammatory strategies, controlling vomiting and pain, promoting emptying, preventing infection, and combination therapy. Being knowledgeable about the most current treatment options, the related adverse effects, and the evidence supporting different practices is critical for clinicians to provide individualized medical therapy for MBO patients.

show abstract

“…However, a paucity of welldesigned randomized studies has left optimal timing of SSA initiation, dosing, and duration of therapy open for interpretation, warranting additional exploration with comparative trials with validated end points. 27 Obita et al 28 conducted a comprehensive systematic review of seven randomized controlled trials (RCTs) comparing SSA (eg, octreotide 200 to 900 mg SC twice a day to three times a day or 300 mg/d via continuous infusion) to placebo or other pharmacologic agents in MBO. The authors identified five trials with low-level evidence suggesting a benefit of SSAs, whereas two trials with higher-level evidence failed to demonstrate benefit.…”

Section: Nonoperative Proceduresmentioning

confidence: 99%

Management of Malignant Bowel Obstruction Associated With GI Cancers

Franke

Iqbal

Starr

et al. 2017

JOP

View full text Add to dashboard Cite

For many patients with GI malignancies, the seeding of the abdominal cavity with tumor cells, called peritoneal carcinomatosis, is a common mode of metastases and disease progression. Prognosis for patients with this aspect of their disease remains poor, with high disease-related morbidity and complications. Uniform and proven practices that provide optimal palliative care and quality of life for these patients are needed. The objective of this review is to critically assess the current literature regarding palliative strategies in the management of peritoneal carcinomatosis and associated symptoms in patients with advanced GI cancers. Despite encouraging results in the select population where cytoreductive surgery and intraperitoneal chemotherapy are indicated, the majority of patients who develop peritoneal carcinomatosis in the setting of GI cancers have poor prognosis, with malignant bowel obstruction representing a common terminal phase of their disease process. For all patients with peritoneal carcinomatosis, aggressive symptom control and early multimodality palliative care as further outlined should be sought.

show abstract

Octreotide prescribing patterns in the palliation of symptomatic inoperable malignant bowel obstruction patients at a single US academic hospital

Cited by 8 publications

References 23 publications

The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

Medical Management of Inoperable Malignant Bowel Obstruction

Management of Malignant Bowel Obstruction Associated With GI Cancers

Contact Info

Product

Resources

About