Zidan, J., Haim, N., Beny, A., Stein, M., Gez, E., & Kuten, A. (2001). Octreotide in the treatment of severe chemotherapy-induced diarrhea. Annals of Oncology, 12(2), 227–229.

Patients with chemotherapy-induced diarrhea (CID) refractory to loperamide received 100 mcg subcutaneous octreotide three times per day for three days followed by 50 mcg three times per day for three days. The median time between chemotherapy and starting octreotide was 8 days (range = 5–9 days).

• The study reported on 32 patients from two cancer centers with grade 2–3 CID (according to World Health Organization [WHO] classification) refractory to loperamide.
• Chemotherapy regimens were 5-fluorouracil (5-FU) and leucovorin (n = 19): irinotecan, 5-FU, and leucovorin (n = 4); 5-FU combination including one or more of cyclophosphamide, epirubicin, cisplatin, methotrexate, and cisplatin (n = 8); and 5-FU combination plus radiation therapy (n = 1).
• Primary tumors were colorectal (23), gastric (3), and other (6).
• Patients initially had received 4 mg loperamide followed by 2 mg every six hours for 48 hours.

This was a prospective study.

Patients recorded the number of bowel movements. Complete response (CR) was defined as no diarrheal stools per day; partial response (PR) was defined as 1–2 diarrheal stools per day; and no response was defined as three or more diarrheal stools per day. Progression was defined as an increase in the number of diarrheal stools.

• The majority of patients (94%) experienced CR. Five patients experienced CR within 24 hours; 14 within 48 hours; and 11 within 72 hours.
• Twelve of the patients who experienced CR discontinued treatment after three days because they reported feeling \"very healthy.\"
• No toxic side effects were documented.

Octreotide was found to be highly effective as second-line therapy in managing patients with CID. 

The sample size was small.