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A Prospective Study on the Efficacy of Octreotide in the Management of Malignant Bowel Obstruction in Gynecologic Cancer
  1. Hidemichi Watari, MD, PhD*,
  2. Masayoshi Hosaka, MD, PhD*,
  3. Yukio Wakui, MD, PhD,
  4. Eiji Nomura, MD, PhD,
  5. Hitoshi Hareyama, MD, PhD§,
  6. Fumie Tanuma, MD,
  7. Rifumi Hattori, MD, PhD,
  8. Masaki Azuma, MD, PhD#,
  9. Hidenori Kato, MD, PhD**,
  10. Naoki Takeda, MD, PhD††,
  11. Satoshi Ariga, MD, PhD‡‡ and
  12. Noriaki Sakuragi, MD, PhD*
  1. *Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine;
  2. Department of Obstetrics and Gynecology, KKR Sapporo Medical Center, Sapporo;
  3. Department of Obstetricsand Gynecology, Ohji General Hospital, Tomakomai;
  4. §Department of Obstetrics and Gynecology, Sapporo City General Hospital, Sapporo;
  5. Department of Obstetrics and Gynecology, Hakodate Central General Hospital, Hakodate;
  6. Department of Obstetrics and Gynecology, Obihiro-Kosei General Hospital, Obihiro;
  7. #Department of Obstetrics and Gynecology, Kushiro Red Cross Hospital, Kushiro;
  8. **Department of Gynecology, Hokkaido Cancer Center, Sapporo;
  9. ††Department of Obstetrics and Gynecology, Sunagawa City Medical Center, Sunagawa; and
  10. ‡‡Department of Obstetrics and Gynecology, Hokkaido Social Insurance Hospital, Sapporo, Japan.
  1. Address correspondence and reprint requests to Hidemichi Watari, MD, PhD, Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, 060-8638, Japan. E-mail: watarih@med.hokudai.ac.jp.

Abstract

Objective Malignant bowel obstruction (MBO), of which symptoms lead to a poor quality of life, is a common and distressing clinical complication in advanced gynecologic cancer. The aim of this study was to prospectively assess the clinical efficacy of octreotide to control vomiting in patients with advanced gynecologic cancer with inoperable gastrointestinal obstruction.

Methods Patients with advanced gynecologic cancer, who presented at least one episode of vomiting per day due to MBO, were enrolled in this prospective study from 2006 to 2009. Octreotide was administered when necessary at doses starting with 300 μg up to 600 μg a day by continuous infusion for 2 weeks. Primary end point was vomiting control, which was evaluated by common terminology criteria for adverse events version 3 (CTCAE v3.0). Adverse events were also evaluated by CTCAE v3.0.

Results Twenty-two cases were enrolled in this study. Octreotide controlled vomiting in 15 cases (68.2%) to grade 0 and 3 cases (13.6%) to grade 1 on CTCAE v3.0. Overall response rate to octreotide treatment was 81.8% in our patients’ cohort. Among 14 cases without nasogastric tube, the overall response rate was 93.1% (13/14). Among 8 cases with nasogastric tube, 4 cases were free of tube with decrease of drainage, and overall response rate was 62.5% (5/8). No major adverse events related to octreotide were reported.

Conclusions We conclude that 300-μg/d dose of octreotide was effective and safe for Japanese patients with MBO by advanced gynecologic cancer. Octreotide could contribute to better quality of life by avoiding placement of nasogastric tube.

  • Octreotide
  • Malignant bowel obstruction
  • Gynecologic cancer
  • Quality of life

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Footnotes

  • Noriaki Sakuragi declares unrestricted funding from Novartis Pharma K.K.

  • Others declare that there are no conflicts of interest.

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (www.ijgc.net).

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