S. Befon et al., Continuous subcutaneous octreotide in gastrointestinal cancer patients: Pain control and beta-endorphin levels, ANTICANC R, 20(5C), 2000, pp. 4039-4046
Background: Somatostatin is a naturally occurring hormone widely identified
in a number of human tissues, with a broad spectrum of physiological actio
ns. Octreotide is a synthetic analogue of somatostatin, which seems to be p
romising in clinical use. Aims: a. to evaluate the efficacy of octreotide i
n pain control of patients with advanced gastrointestinal cancer; as well a
s octreotide's outcome in the hepatic function; b to investigate the relati
onship between pain intensity and beta -endorphin blood levels in the patie
nts. Patients: The study group consisted of 25 patients ( age range: 48-89
years, 14 males, 11 females) with far advanced gastrointestinal cancer. Met
hods: All the patients were under sc, morphine administration using a conti
nuous infusion pump. When pain intensity increased, 0.6 mg/day of octreotid
e was added to the therapeutic regimen in the same syringe of the continuou
s infusion pump. Pain intensity and beta -endorphin blood levels were measu
red five times: Once before octreotide administration and the other four 12
, 24, 48 hours and 7 days after: A complete blood count and a biochemical s
creening profile were taken before the administration of octreotide as well
as on the 7(th) and the 14(th) day. Results: 24 out of 25 cases showed a r
eduction in pain intensity (pretreatment x=5.3, post-treatment x=0.6). beta
-endorphin blood levels increased significantly during the study (an incre
ase of 184.78% was observed on the 7th treatment day). In one patient pain
control was achieved by increasing morphine dosage. Statistically significa
nt changes were observed in hepatic function indices (p<0.02). Significant
side-effects were not observed. Conclusion: Octreotide can be used as an ad
juvant analgesic in the management of gastrointestinal cancer pain which is
managed by continuous sc, administration. Although fuither research needs
to be done, octreotide's administration seemed to improve hepatic function
of these patients, therefore, it could potentially have a positive effect i
n the patient's quality of life.