{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:40:56Z","timestamp":1785328856776,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,12,29]],"date-time":"2015-12-29T00:00:00Z","timestamp":1451347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2016,2]]},"abstract":"Abstract<\/jats:title>Malignant small bowel obstruction (MSBO<\/jats:styled-content>) that does not resolve with conservative measures frequently leaves few treatment options other than palliative care. This single\u2010institution retrospective study assesses the outcomes of a more aggressive approach\u2014concurrent systemic chemotherapy and total parenteral nutrition (TPN<\/jats:styled-content>)\u2014in the treatment of MSBO<\/jats:styled-content>. The MD<\/jats:styled-content> Anderson pharmacy database was queried to identify patients who received concurrent systemic chemotherapy and TPN<\/jats:styled-content> between 2005 and 2013. Only patients with MSBO<\/jats:styled-content> secondary to peritoneal carcinomatosis requiring TPN<\/jats:styled-content> for \u22658\u00a0days were included. Survival and multivariate analyses were performed using the Kaplan\u2013Meier method and Cox proportional hazard models. The study included 82 patients. MSBO<\/jats:styled-content> resolution was observed in 10 patients. Radiographic assessments showed a response to chemotherapy in 19 patients; 6 of these patients experienced MSBO<\/jats:styled-content> resolution. Patients spent an average of 38% of their remaining lives hospitalized, and 28% of patients required admission to the intensive care unit. In multivariate modeling, radiographic response to chemotherapy correlated with MSBO<\/jats:styled-content> resolution (odds ratio [OR<\/jats:styled-content>] 6.81; 95% confidence interval [CI<\/jats:styled-content>], 1.68\u201327.85, P\u00a0<\/jats:italic>=\u00a00.007). Median overall survival (OS<\/jats:styled-content>) was 3.1\u00a0months, and the 1\u2010year OS<\/jats:styled-content> rate was 12.6%. Radiographic response to chemotherapy (HR<\/jats:styled-content> 0.30; 95% CI<\/jats:styled-content>, 0.16\u20130.56, P\u00a0<\/jats:italic><\u00a00.001), and initiation of new chemotherapy during TPN<\/jats:styled-content> (HR<\/jats:styled-content> 0.55; 95% CI<\/jats:styled-content>, 0.33\u20130.94, P\u00a0<\/jats:italic>=\u00a00.026) independently predicted for longer OS<\/jats:styled-content>. Concurrent treatment with systemic chemotherapy and TPN<\/jats:styled-content> for persistent MSBO<\/jats:styled-content> results in low efficacy and a high morbidity and mortality, and thus should not represent a standard approach.<\/jats:p>","DOI":"10.1002\/cam4.587","type":"journal-article","created":{"date-parts":[[2015,12,30]],"date-time":"2015-12-30T04:16:49Z","timestamp":1451449009000},"page":"239-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Retrospective analysis of systemic chemotherapy and total parenteral nutrition for the treatment of malignant small bowel obstruction"],"prefix":"10.1002","volume":"5","author":[{"given":"Jay","family":"Chouhan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine The University of Texas Health Sciences Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine The University of Texas Health Sciences Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Ensor","sequence":"additional","affiliation":[{"name":"Houston Methodist Cancer Center Houston Methodist Research Institute The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanwal","family":"Raghav","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Fogelman","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Wolff","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fisch","sequence":"additional","affiliation":[{"name":"Department of General Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Overman","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,12,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1438.2002.01103.x"},{"key":"e_1_2_7_3_1","first-page":"CD002764","article-title":"Surgery for the resolution of symptoms in malignant bowel obstruction in advanced gynaecological and gastrointestinal cancer","author":"Feuer D. 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