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30.01.2020 | Research Paper

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) of peritoneal metastasis from gastric cancer: a descriptive cohort study

verfasst von: S. Bremholm Ellebæk, M. Graversen, S. Detlefsen, L. Lundell, C. W. Fristrup, P. Pfeiffer, M. B. Mortensen

Erschienen in: Clinical & Experimental Metastasis | Ausgabe 2/2020

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Abstract

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) represents a novel approach to deliver intraperitoneal chemotherapy. We report our experience with PIPAC in patients with peritoneal metastasis (PM) from gastric cancer (GC). Data from GC patients (n = 20) included in the prospective PIPAC-OPC1 and PIPAC-OPC2 studies are reported. All patients had received prior systemic chemotherapy. The mean peritoneal cancer index (PCI) was 10.5 (range 0–39) and nine patients had diffuse GC. PIPAC with cisplatin 7.5 mg/m2 and doxorubicin 1.5 mg/m2 were administered at 4–6-week intervals. Outcome criteria were objective tumour response, survival and adverse events. Twenty patients had 52 PIPAC procedures with a median follow-up of 10.4 months (3.3–26.5). Median survival from the time of PM diagnosis and after the first PIPAC procedure was 11.5 months and 4.7 months, respectively. Fourteen patients had repeated PIPAC (> 2), and the objective tumour response according to the histological peritoneal regression grading score (PRGS) was observed in 36%, whereas 36% had stable disease. Ten patients completed the three prescheduled sessions (per protocol group) and 40% of those displayed an objective tumour response, while 20% had stable disease. Only minor postoperative complications were noted, and none were considered causally related to the PIPAC treatment. PIPAC with low-dose cisplatin and doxorubicin can induce a quantifiable objective tumour response in selected patients with PM from GC. Survival data are encouraging and warrant further clinical studies.
Literatur
8.
Zurück zum Zitat Miyashiro I, Furukawa H, Sasako M et al (2011) Randomized clinical trial of adjuvant chemotherapy with intraperitoneal and intravenous cisplatin followed by oral fluorouracil (UFT) in serosa-positive gastric cancer versus curative resection alone: final results of the Japan Clinical Oncology Group trial JCOG9206-2. Gastric Cancer 14(3):212–218. https://doi.org/10.1007/s10120-011-0027-3 CrossRefPubMed Miyashiro I, Furukawa H, Sasako M et al (2011) Randomized clinical trial of adjuvant chemotherapy with intraperitoneal and intravenous cisplatin followed by oral fluorouracil (UFT) in serosa-positive gastric cancer versus curative resection alone: final results of the Japan Clinical Oncology Group trial JCOG9206-2. Gastric Cancer 14(3):212–218. https://​doi.​org/​10.​1007/​s10120-011-0027-3 CrossRefPubMed
13.
Zurück zum Zitat Nowacki M, Alyami M, Villeneuve L et al (2018) Multicenter comprehensive methodological and technical analysis of 832 pressurized intraperitoneal aerosol chemotherapy (PIPAC) interventions performed in 349 patients for peritoneal carcinomatosis treatment: an international survey study. Eur J Surg Oncol 44(7):991–996. https://doi.org/10.1016/j.ejso.2018.02.014 CrossRefPubMed Nowacki M, Alyami M, Villeneuve L et al (2018) Multicenter comprehensive methodological and technical analysis of 832 pressurized intraperitoneal aerosol chemotherapy (PIPAC) interventions performed in 349 patients for peritoneal carcinomatosis treatment: an international survey study. Eur J Surg Oncol 44(7):991–996. https://​doi.​org/​10.​1016/​j.​ejso.​2018.​02.​014 CrossRefPubMed
16.
Zurück zum Zitat Garg PK, Jara M, Alberto M, Rau B (2019) The role of Pressurized IntraPeritoneal Aerosol Chemotherapy in the management of gastric cancer: a systematic review. Pleura Peritoneum 4(1):20180127CrossRef Garg PK, Jara M, Alberto M, Rau B (2019) The role of Pressurized IntraPeritoneal Aerosol Chemotherapy in the management of gastric cancer: a systematic review. Pleura Peritoneum 4(1):20180127CrossRef
20.
Zurück zum Zitat National Institutes of Health NCI (2009) Common Terminology Criteria for Adverse Events (CTCAE). 4.0 [published Online First: 28.05.2009] National Institutes of Health NCI (2009) Common Terminology Criteria for Adverse Events (CTCAE). 4.0 [published Online First: 28.05.2009]
22.
Zurück zum Zitat Lauren P (1965) The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 64:31–49CrossRef Lauren P (1965) The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 64:31–49CrossRef
26.
Zurück zum Zitat Khomyakov VRA, Ivanov A, Bolotina L, Utkina A et al (2016) Bidirectional chemotherapy in gastric cancer with peritoneal metastasis combining intravenous XELOX with intraperitoneal chemotherapy with low-dose cisplatin and Doxorubicin administered as a pressurized aerosol: an open-label, Phase-2 study (PIPAC-GA2). Pleura Peritoneum 1(3):159–166CrossRef Khomyakov VRA, Ivanov A, Bolotina L, Utkina A et al (2016) Bidirectional chemotherapy in gastric cancer with peritoneal metastasis combining intravenous XELOX with intraperitoneal chemotherapy with low-dose cisplatin and Doxorubicin administered as a pressurized aerosol: an open-label, Phase-2 study (PIPAC-GA2). Pleura Peritoneum 1(3):159–166CrossRef
Metadaten
Titel
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) of peritoneal metastasis from gastric cancer: a descriptive cohort study
verfasst von
S. Bremholm Ellebæk
M. Graversen
S. Detlefsen
L. Lundell
C. W. Fristrup
P. Pfeiffer
M. B. Mortensen
Publikationsdatum
30.01.2020
Verlag
Springer Netherlands
Erschienen in
Clinical & Experimental Metastasis / Ausgabe 2/2020
Print ISSN: 0262-0898
Elektronische ISSN: 1573-7276
DOI
https://doi.org/10.1007/s10585-020-10023-5

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