Bhattacharya S, Vijayasekar C, Worlding J, Mathew G
Department of General and Colorectal Surgery, George Eliot Hospital, Nuneaton, UK CV107DJ.
Acta Gastroenterol Belg. 2009 Jul-Sep;72(3):289-95.
Chemotherapy-induced diarrhoea (CID) is well known in cancer management. The risk is greater when the primary cancer is colorectal. This article aims towards assessing the role of octreotide in CID through an extensive literature search.
After searching through PUBMED, MEDLINE and the Cochrane library, only those studies which were published over the last 20 years in English and where at least the majority of the cohort were colorectal patients, were included. Two randomized trials, four non-randomized studies and two case-series publications were thus considered.
It was seen in both the randomized studies, that octreotide had much better outcome as compared to loperamide in treating severe CID. Among 88 patients from the non-randomized studies with severe CID, the primary cancer was colorectal in 79 patients. 61 patients had drug-resistant CID. Within a maximum of 96 hours, octreotide reduced CID by > or = 2 grades in 91% of 88 patients and in 88.52% patients with drug-resistant CID.
Octreotide is effective in treating severe CID, resistant to other modes of treatment. It is associated with a few minor adverse effects. Though expensive, octreotide could be considered as first line medication in CID of grades 3 or above. Its use in lower grades of CID would not be cost effective.
化疗引起的腹泻（CID）在癌症治疗中广为人知。当原发性癌症为结直肠癌时，风险更高。本文旨在通过广泛的文献检索评估奥曲肽在CID中的作用。
在检索了PUBMED、MEDLINE和Cochrane图书馆后，仅纳入过去20年以英文发表且至少大多数队列研究对象为结直肠癌患者的研究。因此，考虑了两项随机试验、四项非随机研究和两项病例系列出版物。
在两项随机研究中均发现，与洛哌丁胺相比，奥曲肽在治疗严重CID方面有更好的效果。在非随机研究的88例严重CID患者中，79例原发性癌症为结直肠癌。61例患者患有耐药性CID。在最多96小时内，奥曲肽使88例患者中的91%以及88.52%的耐药性CID患者的CID减轻≥2级。
奥曲肽对其他治疗方式耐药的严重CID有效。它伴有一些轻微的不良反应。尽管价格昂贵，但奥曲肽可被视为3级及以上CID的一线用药。其用于较低级别的CID不具有成本效益。
