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- Title
Palliative Medical Management of Inoperable Malignant Bowel Obstruction With "Triple Therapy": Dexamethasone, Octreotide, and Metoclopramide.
- Authors
Wey, Winston; Mian, Moeena; Calabrese, Rebecca; Hansen, Eric; Walter, Michelle; Wang, Chong; Miller, Austin; Case, Amy A.
- Abstract
Context: Malignant bowel obstruction (MBO) is a complication of advanced malignancy. For inoperable patients, symptoms are often treated using analgesics, anticholinergics, and anti-emetics. There are, however, few published guidelines for the medical management of MBO. Objective: To measure the effect of the combination of dexamethasone, octreotide, and metoclopramide ("triple therapy") in patients with MBO, compared to patients who received none of the 3 medications ("no drug therapy"). Methods: A retrospective cohort study of patients with MBO admitted in a single-center comprehensive cancer center. Patients who received dexamethasone, octreotide, and metoclopramide during their hospitalization for treatment of inoperable MBO were selected for analysis. Patients were excluded if they received a venting gastric tube. Rate of de-obstruction as well as time to de-obstruction were measured. Results: There were 20 patients identified who received all 3 drugs of interest, and 29 patients identified who received none of the 3 medications. There was no statistically significant difference in rates of de-obstruction between the 2 groups, though there was a non-significant trend toward patients who received triple therapy were more likely to reach de-obstruction, compared to patients who had no drug therapy (95% vs. 83%, p = 0.379); there was no significant difference in adjusted analysis. Conclusion: In patients with inoperable MBO, there was no statistically significant difference in rates of de-obstruction with triple drug therapy compared to patients who received none of the 3 drugs, though the study may not have been powered to detect a difference and further investigation is warranted.
- Subjects
CANCER treatment; PALLIATIVE treatment; HOSPITAL care; RETROSPECTIVE studies; CANCER patients; DESCRIPTIVE statistics; OCTREOTIDE acetate; TUMORS; METOCLOPRAMIDE; BOWEL obstructions; DEXAMETHASONE; SPECIALTY hospitals
- Publication
American Journal of Hospice & Palliative Medicine, 2021, Vol 38, Issue 4, p340
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/1049909120968249