Octreotide in chemotherapy induced diarrhoea in colorectal cancer : a review article

Background : Chemotherapy-induced diarrhoea (CID) is well known in cancer management. The risk is greater when the pri- mary cancer is colorectal. This article aims towards assessing the role of octreotide in CID through an extensive literature search. Methods : 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 publica- tions were thus considered. Results: 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 = 2 grades in 91% of 88 patients and in 88.52% patients with drug-resistant CID. Conclusion : Octreotide is effective in treating severe CID, resist- ant 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. (Acta gastroenterol. belg., 2009, 72, 289-295).