B Pro1, R Lozano, J A Ajani. 1. Department of Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030-4095, USA.
Abstract
PURPOSE: Severe diarrhea can represent a dose-limiting toxicity with the use of CPT-11. Conventional therapy is ineffective in some patients and is also limited by patient compliance. We report our observation on the effectiveness of octreotide acetate in the treatment of CPT-11-induced diarrhea refractory to opioids. PATIENTS AND METHODS: We describe 4 patients with metastatic gastrointestinal tumors who developed severe diarrhea following treatment with CPT-11 (65-125 mg/m2/weekly for 4 weeks every 6 weeks). Diarrhea was refractory to treatment with loperamide and diphenoxylate and was treated with octreotide acetate. RESULTS: Complete resolution of diarrhea was observed within 2-4 days of octreotide acetate treatment. Three patients responded to SC octreotide given every 8 hours and the 4th patient to octreotide given by continuous s.c. infusion. CONCLUSIONS: Our preliminary observation suggests value of octreotide in the control of CPT-11 induced refractory diarrhea. Prospective studies are warranted.
PURPOSE: Severe diarrhea can represent a dose-limiting toxicity with the use of CPT-11. Conventional therapy is ineffective in some patients and is also limited by patient compliance. We report our observation on the effectiveness of octreotide acetate in the treatment of CPT-11-induced diarrhea refractory to opioids. PATIENTS AND METHODS: We describe 4 patients with metastatic gastrointestinal tumors who developed severe diarrhea following treatment with CPT-11 (65-125 mg/m2/weekly for 4 weeks every 6 weeks). Diarrhea was refractory to treatment with loperamide and diphenoxylate and was treated with octreotide acetate. RESULTS: Complete resolution of diarrhea was observed within 2-4 days of octreotide acetate treatment. Three patients responded to SC octreotide given every 8 hours and the 4th patient to octreotide given by continuous s.c. infusion. CONCLUSIONS: Our preliminary observation suggests value of octreotide in the control of CPT-11 induced refractory diarrhea. Prospective studies are warranted.
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