生长抑素类似物治疗肿瘤化疗相关性腹泻的临床观察

目的评价生长抑素类似物(奥曲肽,下同)对肿瘤化疗相关性腹泻的疗效。方法对58例出现化疗相关性腹泻(CID)的患者给予奥曲肽治疗。按照NCI CTC标准,全组患者出现Ⅱ级腹泻12例,Ⅲ级腹泻38例,Ⅳ级腹泻8例。Ⅱ级、Ⅲ级CID给予皮下注射奥曲肽100μg bid或静脉持续泵入奥曲肽25μg/h,每天8 h,Ⅳ级CID给予静脉持续泵入奥曲肽25μg/h,每天12 h。结果全组58例患者的总有效率为89.7%。Ⅱ级CID奥曲肽治疗平均有效时间为2.6 d;Ⅲ级CID皮下注射奥曲肽的治疗有效时间平均为4.7 d,而静脉持续泵入奥曲肽的治疗天数平均为3.9 d,二者差异有统计学意义(P<0.05);Ⅳ级CID静脉持续泵入奥曲肽治疗平均有效时间为7.5 d。不良反应表现为5例皮下注射的患者出现一过性面部潮红,恶心,未作处理自行缓解。结论奥曲肽能有效地控制肿瘤化疗相关性腹泻,Ⅱ级以上CID患者宜采用静脉持续滴注治疗为宜。

Octreotide in the management of chemotherapy-induced diarrhea in patients with tumors

Objective To evaluate the efficacy of octreotide in the management of chemotherapy-induced diarrhea （CID）. Method Thirty-nine tumor patients with grade 2 to 4 diarrhea were enrolled to receive oetreotide. The patients of grade 2 CID （n =8 ） and Grade 3 CID （ n = 28 ） were treated with octreotide 100 lag two times daily subcutaneously or oetreotide 0.2 mg plus normal saline 50ml keep-on intravenous bolus 8 hours daily, Grade 4 CID （ n = 3） were given ectreotide 0. 3 mg and NS 50 mL keep-on intravenous bolus 22 hours daily. Result Diarrhea mainly occurred in the first 2 weeks of chemotherapy and completely resolved in 34 patients （ 87. 2% ） following octreotide administration. Mean time to response was 2.6 days in patients with grade 2 CID, 4.9 days and 3.8 days in patients with grade 3 CID respectively by subeutanecus and intravenous bolus, 7.0 days in patients with grade 4 CID. No significant side effect was reported. Conclusion Oetreotide is highly effective in antidiarrheal treatment of patients with CID, and should be administered by keep-on intravenous bolus for patients with grade 3 or 4 CID.