Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Int J Gynecol Cancer. 2012 May;22(4):692-6. doi: 10.1097/IGC.0b013e318244ce93.
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.
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.
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.
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.
恶性肠梗阻（MBO）是晚期妇科癌症中常见且令人痛苦的临床并发症，其症状导致生活质量较差。本研究旨在前瞻性评估奥曲肽控制不可手术胃肠道梗阻的晚期妇科癌症患者呕吐的临床疗效。
本前瞻性研究纳入了 2006 年至 2009 年间至少每天因 MBO 出现一次呕吐的晚期妇科癌症患者。奥曲肽以 300μg 起始剂量，每日持续输注，剂量最高可达 600μg，持续 2 周。主要终点为呕吐控制，通过不良事件通用术语标准 3.0 版（CTCAE v3.0）进行评估。也通过 CTCAE v3.0 评估不良事件。
本研究纳入了 22 例患者。奥曲肽使 15 例（68.2%）患者的呕吐在 CTCAE v3.0 中达到 0 级，3 例（13.6%）患者达到 1 级。奥曲肽治疗的总有效率为 81.8%。在 14 例无鼻胃管的患者中，总有效率为 93.1%（13/14）。在 8 例有鼻胃管的患者中，4 例患者在减少引流的同时解除了置管，总有效率为 62.5%（5/8）。未报告与奥曲肽相关的严重不良事件。
我们的结论是，300μg/d 剂量的奥曲肽对日本晚期妇科癌症合并 MBO 患者有效且安全。奥曲肽可以避免放置鼻胃管，从而提高生活质量。
