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

胃癌腹膜转移的加压腹腔气溶胶化疗 (PIPAC): 一项描述性队列研究。

  • 影响因子:3.10
  • DOI:10.1007/s10585-020-10023-5
  • 作者列表:"Ellebæk SB","Graversen M","Detlefsen S","Lundell L","Fristrup CW","Pfeiffer P","Mortensen MB
  • 发表时间:2020-01-30
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.

摘要

: 加压腹膜内气溶胶化疗 (PIPAC) 代表了一种提供腹腔内化疗的新方法。我们报告了我们在胃癌 (GC) 腹膜转移 (PM) 患者中使用 PIPAC 的经验。本文报告了前瞻性 PIPAC-OPC1 和 PIPAC-OPC2 研究中 GC 患者 (n = 20) 的数据。所有患者均既往接受过全身化疗。平均腹膜癌指数 (PCI) 为 10.5 (范围 0-39),9 例患者有弥漫性 GC。PIPAC 联合顺铂 7.5 mg/m2 和多柔比星 1.5 mg/m2,间隔 4-6 周。结果标准为客观肿瘤反应、生存和不良事件。20 例患者进行了 52 次 PIPAC 手术,中位随访时间为 10.4 个月 (3.3-26.5)。从 PM 诊断开始和第一次 PIPAC 手术后的中位生存期分别为 11.5 个月和 4.7 个月。14 例患者重复 PIPAC (> 2),根据组织学腹膜回归分级评分 (PRGS) 观察到的客观肿瘤反应为 36%,而 36% 的患者病情稳定。10 例患者完成了 3 次预先安排的治疗 (按方案组),40% 的患者显示客观的肿瘤反应,而 20% 的患者疾病稳定。仅观察到轻微的术后并发症,无一例被认为与 PIPAC 治疗有因果关系。PIPAC 联合低剂量顺铂和多柔比星可以在来自 GC 的 PM 患者中诱导可量化的客观肿瘤反应。生存数据令人鼓舞,需要进一步的临床研究。

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