Kubota Hiroki, Taguchi Kazumi, Kobayashi Daichi, Naruyama Hiromichi, Hirose Masahito, Fukuta Katsuhiro, Kubota Yasue, Yasui Takahiro, Yamada Yasuyuki, Kohri Kenjiro
Department of Urology, Kainan Hospital, Yatomi, Japan E-mail :
Asian Pac J Cancer Prev. 2013;14(12):7107-10. doi: 10.7314/apjcp.2013.14.12.7107.
Malignant bowel obstruction (MBO), an occasional complication in patients with advanced urological cancer, causes gastrointestinal symptoms such as nausea and vomiting leading to suffering which severely impairs quality of life (QOL). Drug therapy, especially octreotide, a synthetic analog of somatostatin, is reportedly effective in controlling the symptoms of MBO. In the present study, we administered octreotide to urological cancer patients with MBO and evaluated the improvement of subjective symptoms, oral intake, and nasogastric intubation. Fourteen terminally ill urological cancer patients suffering with MBO were included (age range 55-92, 10 male, 4 female). Octreotide was administered at 300μg/day to those patients subcutaneously as a continuous injection. Significant improvements in subjective symptoms were observed in thirteen patients (92.8%), and ten patients (71.4%) were able to resume oral intake. Four patients required nasogastric drainage before the administration of octreotide, but nasogastric intubation was discontinued in all these cases after the use of octreotide. Early initiation of octreotide resulted in better improvement of MBO symptoms, and no adverse event was observed in any of the patients. These results revealed that 300μg/day dose of octreotide is safe and effective for managing gastrointestinal symptoms of terminally ill urological cancer patients with MBO. We also recommend starting the treatment with ocreotide as soon as MBO is diagnosed.
恶性肠梗阻（MBO）是晚期泌尿系统癌症患者偶尔出现的并发症，会引发恶心、呕吐等胃肠道症状，导致患者痛苦，严重损害生活质量（QOL）。据报道，药物治疗，尤其是生长抑素的合成类似物奥曲肽，对控制MBO症状有效。在本研究中，我们对患有MBO的泌尿系统癌症患者给予奥曲肽，并评估主观症状、口服摄入量和鼻胃管插管情况的改善。纳入了14名患有MBO的晚期泌尿系统癌症患者（年龄范围55 - 92岁，男性10名，女性4名）。以300μg/天的剂量对这些患者进行皮下持续注射奥曲肽。13名患者（92.8%）的主观症状有显著改善，10名患者（71.4%）能够恢复口服摄入。4名患者在使用奥曲肽前需要鼻胃管引流，但在使用奥曲肽后所有这些病例的鼻胃管插管均停止。早期开始使用奥曲肽可使MBO症状得到更好改善，且所有患者均未观察到不良事件。这些结果表明，300μg/天剂量的奥曲肽对治疗患有MBO的晚期泌尿系统癌症患者的胃肠道症状是安全有效的。我们还建议一旦诊断出MBO，应尽快开始使用奥曲肽进行治疗。
