The use of steroids in the management of inoperable intestinal obstruction in terminal cancer patients: do they remove the obstruction?
| Autor: | C Haond, J Girardier, G Laval, R Schaerer, J M Lassaunière, B Leduc |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Palliative care Anti-Inflammatory Agents Placebo Methylprednisolone law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial 030502 gerontology law Intestinal Neoplasms Humans Medicine Aged Terminal Care business.industry Palliative Care General Medicine Middle Aged medicine.disease Surgery Clinical trial Bowel obstruction Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Prednisolone Vomiting Female medicine.symptom 0305 other medical science business Intestinal Obstruction medicine.drug |
| Zdroj: | Palliative Medicine. 14:3-10 |
| ISSN: | 1477-030X 0269-2163 |
| DOI: | 10.1191/026921600669298725 |
| Popis: | This multicentre, randomized double-blind study was undertaken to assess the efficacy of corticosteroids as a palliative treatment of intestinal obstruction due to advanced and incurable cancer. Thirty-one French palliative care units agreed to participate in the study and 12 actually recruited at least one patient. To be included, patients had to have an advanced cancer with a surgically inoperable bowel obstruction and to have received no specific anticancer therapy within the preceding 28 days. They had to fulfil at least three of the following criteria: vomiting at least twice a day; colicky abdominal pain; no flatus for 12 h or more; no stool for at least 4 days, faecal impaction being excluded; intestinal distension; air–fluid levels or absence of gas in the colon on an abdominal radiograph. Patients were randomized in three groups to receive either a placebo for 3 days (group A), or methylprednisolone 240 mg daily for 3 days (group B) or methylprednisolone 40 mg daily for 3 days (group C). Symptoms were assessed daily but success or failure of the treatment was assessed on day 4, according to the disappearance or persistence of symptoms. Fifty-eight patients were randomized, of whom 52 were able to be evaluated. Details of symptoms and associated treatments are described below. Of 40 patients without a nasogastric tube, symptoms were relieved in 68% of cases versus 33% among placebo-treated patients (P = 0.047). In 12 patients who had a nasogastric tube already in place, the results are less significant (60% versus 33% with P = 0.080). Because of the small sample size, no conclusions can be reached about the relative efficacy of low versus high-dose treatment regimes. |
| Databáze: | OpenAIRE |
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