O'Toole D, Ducreux M, Bommelaer G, Wemeau J L, Bouché O, Catus F, Blumberg J, Ruszniewski P
Department of Gastroenterology, Hôpital Beaujon, Clichy, France.
Cancer. 2000 Feb 15;88(4):770-6. doi: 10.1002/(sici)1097-0142(20000215)88:4<770::aid-cncr6>3.0.co;2-0.
The somatostatin analogues lanreotide and octreotide have previously been shown to be effective in controlling flushing and diarrhea in patients with carcinoid syndrome. As lanreotide requires injection only every 10 days, compared with twice-daily injections of octreotide, a direct comparison between these two treatments in terms of patient acceptability, patient preference, and efficacy in controlling symptoms was performed in patients with carcinoid syndrome.
Thirty-three patients with carcinoid syndrome were included in an open, multicenter, crossover study. Half of the patients received octreotide 200 microg subcutaneously twice or thrice daily for 1 month followed by lanreotide 30 mg intramuscularly every 10 days for 1 month, while the other half commenced with lanreotide followed by octreotide in a similar fashion. Quality-of-life assessments were performed at each visit and patient preference for one of the two treatments evaluated. The number and intensity of flushing episodes and bowel movements, urinary 5-hydroxyindoleacetic acid (5HIAA) levels, and plasma serotonin levels were recorded.
No significant differences were found between lanreotide and octreotide in terms of quality of life. The majority of patients (68%) preferred lanreotide (P = 0.03), largely due to its simplified mode of administration. Disappearance or improvement in flushes occurred in 53.8% of patients (14 of 26) while on lanreotide and in 68% (17 of 25) on octreotide. A disappearance or improvement of diarrhea in 45.4% (10 of 22) on lanreotide, compared with 50% (11 of 22) on octreotide, was also observed. Lanreotide and octreotide were equally effective in reducing urinary 5HIAA levels and plasma serotonin levels. Both treatments were well tolerated, with mild symptoms of abdominal pain and nausea observed in 29% and 14% receiving octreotide and lanreotide, respectively.
Lanreotide and octreotide are equally efficacious in terms of symptom control and reduction in tumor cell markers for patients with carcinoid syndrome. Due to its simplified mode of administration, most patients prefer treatment with lanreotide.
生长抑素类似物兰瑞肽和奥曲肽此前已被证明可有效控制类癌综合征患者的潮红和腹泻。由于兰瑞肽只需每10天注射一次，而奥曲肽需要每日注射两次，因此对这两种治疗方法在类癌综合征患者的患者可接受性、患者偏好及症状控制疗效方面进行了直接比较。
33例类癌综合征患者纳入一项开放、多中心、交叉研究。一半患者每日皮下注射奥曲肽200微克两次或三次，持续1个月，随后每10天肌肉注射兰瑞肽30毫克，持续1个月，而另一半患者以类似方式先使用兰瑞肽，后使用奥曲肽。每次就诊时进行生活质量评估，并评估患者对两种治疗方法之一的偏好。记录潮红发作次数和强度、排便情况、尿5-羟吲哚乙酸（5HIAA）水平及血浆血清素水平。
兰瑞肽和奥曲肽在生活质量方面无显著差异。大多数患者（68%）更喜欢兰瑞肽（P = 0.03），主要是因为其给药方式更简便。使用兰瑞肽时，53.8%的患者（26例中的14例）潮红消失或改善，使用奥曲肽时为68%（25例中的17例）。使用兰瑞肽时，45.4%（22例中的10例）腹泻消失或改善，使用奥曲肽时为50%（22例中的11例）。兰瑞肽和奥曲肽在降低尿5HIAA水平和血浆血清素水平方面同样有效。两种治疗耐受性均良好，接受奥曲肽和兰瑞肽治疗的患者分别有29%和14%出现轻度腹痛和恶心症状。
对于类癌综合征患者，兰瑞肽和奥曲肽在症状控制及降低肿瘤细胞标志物方面疗效相当。由于给药方式更简便，大多数患者更喜欢使用兰瑞肽进行治疗。
