title: A prospective study on the efficacy of octreotide in the management of malignant bowel obstruction in gynecologic cancer.
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.
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. watarih@med.hokudai.ac.jp
authors.forename: Hidemichi
authors.initials: H
authors.lastname: Watari
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Hosaka
authors.forename: Yukio
authors.initials: Y
authors.lastname: Wakui
authors.forename: Eiji
authors.initials: E
authors.lastname: Nomura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hareyama
authors.forename: Fumie
authors.initials: F
authors.lastname: Tanuma
authors.forename: Rifumi
authors.initials: R
authors.lastname: Hattori
authors.forename: Masaki
authors.initials: M
authors.lastname: Azuma
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kato
authors.forename: Naoki
authors.initials: N
authors.lastname: Takeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ariga
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005833:Genital Neoplasms, Female / Q000150:complications* / Q000628:therapy; D006801:Humans; D007415:Intestinal Obstruction / Q000188:drug therapy* / Q000209:etiology; D007441:Intubation, Gastrointestinal; D008875:Middle Aged; D009367:Neoplasm Staging; D015282:Octreotide / Q000627:therapeutic use*; D010166:Palliative Care; D011379:Prognosis; D011446:Prospective Studies; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; D015282:Octreotide