Clinical Impact of Palliative Treatment Using Octreotide for Inoperable Malignant Bowel Obstruction Caused by Advanced Urological Cancer

  • Kubota, Hiroki (Department of Urology, Kainan Hospital) ;
  • Taguchi, Kazumi (Department of Nephro-urology, Nagoya City University Graduate School of Medical Science) ;
  • Kobayashi, Daichi (Department of Nephro-urology, Nagoya City University Graduate School of Medical Science) ;
  • Naruyama, Hiromichi (Department of Urology, Kainan Hospital) ;
  • Hirose, Masahito (Department of Urology, Kainan Hospital) ;
  • Fukuta, Katsuhiro (Department of Urology, Kainan Hospital) ;
  • Kubota, Yasue (Department of Nephro-urology, Nagoya City University Graduate School of Medical Science) ;
  • Yasui, Takahiro (Department of Nephro-urology, Nagoya City University Graduate School of Medical Science) ;
  • Yamada, Yasuyuki (Department of Urology, Kainan Hospital) ;
  • Kohri, Kenjiro (Department of Nephro-urology, Nagoya City University Graduate School of Medical Science)
  • Published : 2013.12.31


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 $300{\mu}g/day$ 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 $300{\mu}g/day$ 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.


  1. Bozzetti F, Cozzaglio L, Biganzoli E, et al (2002). Quality of life and length of survival in advanced cancer patients on home parenteral nutrition. Clin Nutr, 21, 281-8.
  2. Davis MP, Nouneh C (2000). Modern management of cancerrelated intestinal obstruction. Curr Opin Oncol, 2, 343-50.
  3. Hisanaga T, Shinjo T, Morita T, et al (2010). Multicenter prospective study on efficacy and safety of octreotide for inoperable malignant bowel obstruction. Jpn J Clin Oncol, 40, 739-45.
  4. Khoo D, Hall E, Motson R, et al (1994). Palliation of malignant intestinal obstruction using octreotide. Eur J Cancer, 30, 28-30.
  5. Mercadante S, Ripamonti C, Casuccio A (2000). Comparison of octreotide and hyoscine butylbromide in controlling gastrointestinal symptoms due to malignant bowel obstruction. Support Care Cancer, 8, 188-91.
  6. Mercadante S, Ferrera P, Villari P, Marrazzo A (2004). Aggressive pharmacological treatment for reversing malignant bowel obstruction. J Pain Symptom Manage, 28, 412-16.
  7. Mercadante S, Casuccio A, Mangione S (2007). Medical treatment for inoperable malignant bowel obstruction: a qualitative systematic review. J Pain Symptom Manage, 33, 217-23.
  8. Mercadante S, Porzio G (2012). Octreotide for malignant bowel obstruction: Twenty years after. Clin Rev Oncol/Hematol, 83, 388-92.
  9. Mystakidou K, Tsilika E, Kalaidopoulou O, et al (2000). Comparison of octreotide administration vs conservative treatment in the management of inoperable bowel obstruction in patients with far advanced cancer: a randomized, doubleblind, controlled clinical trial. Anticancer Res, 22, 1187-92.
  10. O'Connor B, Creedon B (2011). Pharmacological treatment of bowel obstruction in cancer patients. Expert Opin Pharmacother, 12, 2205-14.
  11. Philip J, Depczynski B (1997). The role of total parenteral nutrition for patients with irreversible bowel obstruction secondary to gynecological malignancy. J Pain Symptom Manage, 13, 104-11.
  12. Ripamonti C, Mercadante S, Groff L, et al (2000). Role of octreotide, scopolamine butylbromide, and hydration in symptom control of patients with inoperable bowel obstruction and nasogastric tubes: a prospective randomized trial. J Pain Symptom Manage, 19, 23-34.
  13. Ripamonti C, Mercadante S (2005). Pathophysiology and management of malignant bowel obstruction. In: Doyle D, Hanks GW, McDonald N, Cherny N eds. Oxford textbook of palliative medicine, 3rd edition. Oxford University Press, New York. 496-506.
  14. Tuca A, Guell E, Martinez-Losada E, et al (2012). Malignant bowel obstruction in advanced cancer patients: epidemiology, management, and factors influencing spontaneous resolution. Cancer Management Res, 4, 159-69.
  15. WHO Handbook for Reporting Results of Cancer Treatment (1979). WHO, Geneva, 1979.

Cited by

  1. Phase II Study on EANI Combined with Hydrochloride Palonosetron for Prevention of Chemotherapy-induced Nausea and Vomiting Following Highly Emetogenic Chemotherapy vol.15, pp.9, 2014,