Role of octreotide in post chemotherapy and/or radiotherapy diarrhea: prophylaxis or therapy?

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Abstract

Aim

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.

Methods

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.

Results

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).

Conclusion

In chemoradiotherapy-induced diarrhea, octreotide is best used as a therapeutic rather than a prophylactic agent against diarrhea.

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