Sun Ju-Xian, Yang Ning
Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, China.
Asia Pac J Clin Oncol. 2014 Jun;10(2):e108-13. doi: 10.1111/ajco.12055. Epub 2013 Jan 8.
The clinical efficacy of octreotide in controlling chemoradiotherapy-induced diarrhea remains controversial. We conducted a meta-analysis of randomized controlled trials (RCT) comparing octreotide with placebo in the prevention or therapy of chemoradiotherapy-induced diarrhea.
A computerized literature search of Medline, EMBASE, Cochrane Library and BIOSIS databases were performed for RCT comparing the use of octreotide versus placebo in the management of patients with chemoradiotherapy-induced diarrhea. The main outcome measure was the response of the diarrhea.
We included eight RCT comprising 572 patients. We found octreotide was significantly effective compared with the placebo (OR, 4.9; 95%, 1.58-15.2).The overall effect of octreotide was 69% (204/294), while that of placebo was 54% (149/278). When divided into prophylactic and therapeutic subgroups, the prophylactic subgroup had an OR of 2.11 (95% CI, 0.51-2.89) for chemoradiotherapy-induced diarrhea and the therapeutic subgroup had an OR of 7.30 (95% CI, 4.09-13.04).
In chemoradiotherapy-induced diarrhea, octreotide is best used as a therapeutic rather than a prophylactic agent against diarrhea.
奥曲肽在控制放化疗所致腹泻方面的临床疗效仍存在争议。我们进行了一项随机对照试验（RCT）的荟萃分析，比较奥曲肽与安慰剂在预防或治疗放化疗所致腹泻中的作用。
通过计算机检索Medline、EMBASE、Cochrane图书馆和BIOSIS数据库，查找比较奥曲肽与安慰剂用于治疗放化疗所致腹泻患者的RCT。主要观察指标为腹泻的反应。
我们纳入了8项RCT，共572例患者。我们发现奥曲肽与安慰剂相比有显著疗效（OR，4.9；95%，1.58 - 15.2）。奥曲肽的总体有效率为69%（204/294），而安慰剂为54%（149/278）。当分为预防和治疗亚组时，预防亚组对于放化疗所致腹泻的OR为2.11（95%CI，0.51 - 2.89），治疗亚组的OR为7.30（95%CI，4.09 - 13.04）。
在放化疗所致腹泻中，奥曲肽最好用作腹泻的治疗药物而非预防药物。
