GuidelineSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2021
Medical management of malignant bowel obstruction in patients with advanced cancer: 2021 MASCC guideline update.
Guideline in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review.Palliative medicine · 2022Pooled it
- Management of malignant bowel obstruction in patients with advanced cancer at the end of life.Radiology and oncology · 2026Review
- Review
- Management of Nausea and Vomiting in Palliative Care - Real Life Data From a Palliative Care Unit in Germany.The American journal of hospice & palliative care · 2025Observational
- Feasibility and benefit of decompressive percutaneous endoscopic gastrostomy (dPEG) in advanced cancer patients with malignant bowel obstruction.Endoscopy international open · 2024Article
- MetaCGRP is a high-precision meta-model for large-scale identification of CGRP inhibitors using multi-view information.Scientific reports · 2024Article
- Can we improve the management of inoperable malignant bowel obstruction? Results of a feasibility study of elemental diet as an alternative to parenteral nutrition in patients with advanced gynaecological cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Article
- Cancer management from a chronic gastrointestinal function perspective.Clinical medicine (London, England) · 2023Review
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMalignant bowel obstruction (MBO) is a frequent complication in patients with advanced cancer, particularly colon or gynecological malignancies. MASCC previously published a guideline for symptom management of MBO in 2017. This is a 5-year update.
methodA systematic search and review of relevant literature includes a review published in 2010 and 2017. The guideline update used the same literature search process as followed in 2015. The dates of the new search included 2015 up to February 2, 2021. The guidelines involved the pharmacologic management of nausea and vomiting in malignant bowel obstruction (MBO) only. Only randomized trials were included in the updated guideline as evidence. The evidence was reviewed by the panel and the MASCC criteria for establishing a guideline were followed using MASCC level of grading and category of evidence.
resultsThere was one systematic review and 3 randomized trials accepted as evidence from 257 abstracts. Octreotide is effective in reducing gastrointestinal secretions and colic and thereby reduces nausea and vomiting caused by MBO. Scopolamine butylbromide is inferior to octreotide in the doses used in the comparison study. Olanzapine or metoclopramide may be effective in reducing nausea and vomiting secondary to partial bowel obstructions. The panel suggests using either drug. Additional studies are needed to clarify benefits. Haloperidol has been used by convention as an antiemetic but has not been subjected to a randomized comparison. Ranitidine plus dexamethasone may be effective in reducing nausea and vomiting from MBO but cannot be recommended until there is a comparison with octreotide. DISCUSSION: Octreotide remains the drug of choice in managing MBO. Ranitidine was used in one randomized trial in all participants and so its effectiveness as a single drug is not known until there is a randomized comparison with octreotide. Antiemetics such as metoclopramide and olanzapine may be effective, but we have very few randomized trials of antiemetics in MBO.
conclusionThe panel recommends octreotide in non-operable MBO. Randomized trials are needed to clarify ranitidine and antiemetic choices.
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