title: Randomized clinical trial comparing octreotide and scopolamine butylbromide in symptom control of patients with inoperable bowel obstruction due to advanced ovarian cancer.
abstract: BACKGROUND
  The aim of this randomized controlled study was to determine whether octreotide (OCT) or scopolamine butylbromide (SB) was the more effective antisecretive drug controlling gastrointestinal (GI) symptoms due to malignant bowel obstruction (MBO) caused by advanced ovarian cancer.
  
  
  METHODS
  Ninety-seven advanced ovarian cancer patients with inoperable MBO were randomized to OCT 0.3 mg/day (OCT group, n = 48) or SB 60 mg/day (SB group, n = 49) for 3 days through a continuous subcutaneous infusion. The following parameters were measured: episodes of vomiting, nausea, dry mouth, drowsiness, and continuous and colicky pain, using a Likert scale corresponding to a numerical value (none 0, slight 1, moderate 2, severe 3) recorded before starting the treatment (T0) and 24 h (T1), 48 h (T2), and 72 h after (T3) and the daily quantity of GI secretions through the Nasogastric tube (NGT) during the period of study. One patient in the SB group is not included in any assessments since she withdrew consent prior to receiving any treatment because of rapidly progressing cancer.
  
  
  RESULTS
  OCT significantly reduced the amount of GI secretions at T1, T2, and T3 (P < 0.05) compared with SB. NGT secretions significantly reduced at T1, T2, and T3 compared with T0 (P < 0.05) in the OCT group, while in the SB group, only at T3, NGT secretions significantly reduced compared with T0. OCT treatment induced a significantly rapid reduction in the number of daily episodes of vomiting and intensity of nausea compared with SB treatment. No significant changes were observed in dry mouth, drowsiness, and colicky pain after either drug. Continuous pain values were significantly lower in the OCT group than in the SB group at T2 and T3 (P < 0.05).
  
  
  CONCLUSIONS
  At the doses used in this study, OCT was more effective than SB in controlling gastrointestinal symptoms of bowel obstruction. Further studies are necessary to understand the role of hydration more clearly in such a clinical situation.
authors.affiliation: Department of general surgery, QiLu hospital of Shandong University, Jinan, 250012, PR China. pengxingang2014@163.com.
authors.forename: Xingang
authors.initials: X
authors.lastname: Peng
authors.affiliation: Department of Emergency General Surgery, The affiliated hospital of Qingdao University, Qingdao, 266003, PR China. wangpeige2@163.com.
authors.forename: Peige
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Emergency General Surgery, The affiliated hospital of Qingdao University, Qingdao, 266003, PR China. shikuanli14@163.com.
authors.forename: Shikuan
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of general surgery, QiLu hospital of Shandong University, Jinan, 250012, PR China. zhangguangyong3@163.com.
authors.forename: Guangyong
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of general surgery, QiLu hospital of Shandong University, Jinan, 250012, PR China. husanyuan1@163.com.
authors.forename: Sanyuan
authors.initials: S
authors.lastname: Hu
mesh_terms: D002086:Butylscopolammonium Bromide / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007415:Intestinal Obstruction / Q000188:drug therapy* / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications* / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D015282:Octreotide / Q000627:therapeutic use*; D010051:Ovarian Neoplasms / Q000150:complications* / Q000473:pathology; D010276:Parasympatholytics / Q000627:therapeutic use; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000556:secondary; D010997:Pleural Neoplasms / Q000150:complications* / Q000556:secondary; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D005765:Gastrointestinal Agents; D010276:Parasympatholytics; D002086:Butylscopolammonium Bromide; D015282:Octreotide