title: A pilot study of long-acting octreotide for symptomatic malignant ascites.
abstract: BACKGROUND
  Effective, non-invasive, palliative strategies for symptomatic malignant ascites are unavailable. This trial explored whether octreotide, an inhibitor of vascular endothelial growth factor, a putative mediator of ascites, prolongs the interval to next paracentesis.
  
  
  METHODS
  After a baseline paracentesis and a test of short-acting agent, patients with symptomatic ascites were randomly assigned to long-acting octreotide (Sandostatin LAR®) depot 30 mg intramuscularly every month versus 0.9% sodium chloride administered similarly. Patients were then monitored for recurrent, symptomatic ascites.
  
  
  RESULTS
  Thirty-three patients were enrolled: 16 assigned to the octreotide and 17 to the control arm. The median time to next paracentesis was 28 and 14 days in the octreotide and placebo arm, respectively (p = 0.17). After adjustment for extracted ascites volume and abdominal girth change, no statistically significant difference between the groups was observed (hazard ratio = 0.52, with a 95% confidence interval of 0.21-1.28; p = 0.15, per Cox model). Octreotide-treated patients described less of abdominal bloating (p = 0.01), abdominal discomfort (p = 0.02), and shortness of breath (p = 0.007) at one month, although other quality of life symptoms were comparable between the arms. Long-acting octreotide was reasonably well tolerated.
  
  
  CONCLUSIONS
  As prescribed in this trial, octreotide did not seem effective in prolonging the time to next paracentesis, although improvements in symptoms suggest that vascular endothelial growth factor inhibition merits further investigation.
authors.affiliation: Mayo Clinic Rochester, Rochester, MN 55905, USA. Jatoi.aminah@mayo.edu
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
authors.forename: Jorge J
authors.initials: JJ
authors.lastname: Nieva
authors.forename: Rui
authors.initials: R
authors.lastname: Qin
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Wos
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Novotny
authors.forename: Dennis F
authors.initials: DF
authors.lastname: Moore
authors.forename: Rex B
authors.initials: RB
authors.lastname: Mowat
authors.forename: Naftali
authors.initials: N
authors.lastname: Bechar
authors.forename: Eduardo R
authors.initials: ER
authors.lastname: Pajon
authors.forename: Lynn C
authors.initials: LC
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage* / Q000009:adverse effects; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D010865:Pilot Projects; D011788:Quality of Life; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: D042461:Vascular Endothelial Growth Factor A; D015282:Octreotide