Continuous subcutaneous octreotide in gastrointestinal cancer patients: Pain control and beta-endorphin levels

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.