Role of octreotide in post chemotherapy and/or radiotherapy diarrhea: prophylaxis or therapy?

Aim: The clinical efficacy of octreotide in controlling chemoradiotherapy-induced diarrhea remains controversial. We conducted a meta-analysis of randomized controlled trials (RCT) comparing octreotide with placebo in the prevention or therapy of chemoradiotherapy-induced diarrhea.

Methods: A computerized literature search of Medline, EMBASE, Cochrane Library and BIOSIS databases were performed for RCT comparing the use of octreotide versus placebo in the management of patients with chemoradiotherapy-induced diarrhea. The main outcome measure was the response of the diarrhea.

Results: We included eight RCT comprising 572 patients. We found octreotide was significantly effective compared with the placebo (OR, 4.9; 95%, 1.58-15.2).The overall effect of octreotide was 69% (204/294), while that of placebo was 54% (149/278). When divided into prophylactic and therapeutic subgroups, the prophylactic subgroup had an OR of 2.11 (95% CI, 0.51-2.89) for chemoradiotherapy-induced diarrhea and the therapeutic subgroup had an OR of 7.30 (95% CI, 4.09-13.04).

Conclusion: In chemoradiotherapy-induced diarrhea, octreotide is best used as a therapeutic rather than a prophylactic agent against diarrhea.