RT Journal Article
SR Electronic
T1 Malignant bowel obstruction: effectiveness and safety of systemic chemotherapy
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP e1882
OP e1888
DO 10.1136/bmjspcare-2020-002656
VO 14
IS e2
A1 Caparica, Rafael
A1 Amorim, Larissa
A1 Amaral, Paulo
A1 Uratani, Lucas
A1 Muniz, David
A1 Hendlisz, Alain
A1 de Azambuja, Evandro
A1 Glasberg, João
A1 Takahashi, Tiago Kenji
A1 Filho, Elias Abdo
A1 Canellas, Rodrigo
A1 Saragiotto, Daniel
A1 Sabbaga, Jorge
A1 Mak, Milena
YR 2024
UL http://spcare.bmj.com/content/14/e2/e1882.abstract
AB Objectives Although systemic chemotherapy is often administered to patients with malignant bowel obstruction (MBO), its benefit remains unknown. This study assessed the outcomes of patients who received systemic chemotherapy as part of MBO treatment.Methods For this retrospective cohort study, data were extracted from records of patients hospitalised due to MBO in a tertiary cancer centre from 2008 to 2020. Eligible patients were not candidates for surgery and received systemic chemotherapy targeting the underlying malignancy causing MBO. Primary objective was to assess patient outcomes after chemotherapy; secondary objectives were rates of intestinal function recovery, hospital discharge and grade ≥3 toxicities. The primary endpoint was overall survival (OS).Results A total of 167 patients were included: median age was 55 (18–81) years, 91% had an Eastern Cooperative Oncology Group (ECOG) performance status ≥2, 75.5% had gastrointestinal tumours and 70% were treatment-naive. The median OS after chemotherapy was 4.4 weeks (95% CI 3.4 to 5.5) in the overall population. No OS difference was observed according to treatment line (p=0.24) or primary tumour (p=0.13). Intestinal function recovery occurred in 87 patients (52%), out of whom 21 (24.1%) had a reobstruction. Hospital discharge was possible in 74 patients (44.3%). Grade≥3 adverse events occurred in 26.9% of the patients, and a total of 12 deaths (7%) attributed to toxicities were observed after chemotherapy.Conclusions MBO was associated with a dismal prognosis in this mostly treatment-naive population. The administration of chemotherapy yielded a significant risk of toxicities, whereas it did not appear to provide any relevant survival benefit in this scenario.Data are available on reasonable request. The datasets generated during the current study are not publicly available due to local Institutional policies, but may be available from the corresponding author on reasonable request.