Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for unresectable peritoneal metastasis from gastric cancer
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for unresectable peritoneal metastasis from gastric cancer
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DOI：
10.1016/j.ejso.2020.05.021
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发表时间：
2021-01-01
期刊：
影响因子：
3.8
通讯作者：
Glehen, Olivier
中科院分区：
文献类型：
--
作者：
Alyami, Mohammad;Bonnot, Pierre-Emmanuel;Glehen, Olivier
背景：PIPAC是一种治疗腹膜转移（PM）患者的最新方法，具有良好的效果。我们的目的是评估患者的生存率和术后结果与化疗和PIPAC.Methods：一个前瞻性的维护PIPAC数据库进行了回顾性分析，所有患者诊断为不可切除的PM胃癌谁接受PIPAC 2018年之前。PIPAC联合顺铂7.5mg/m2和阿霉素1.5mg/m2，每6周给药一次，每次30 min。结果：42例患者共进行了163次PIPAC治疗，总生存率和不良事件发生率均符合CTCAE 4.0版标准。22例（52%）患者为女性。在33/42例患者（78.6%）中观察到印戒细胞。第一次PIPAC时，中位年龄为51.5岁（32-74岁）。中位PCI为17（1-39）。20例（47.6%）患者在PIPAC前接受了2线以上化疗。所有患者均接受全身化疗与PIPAC交替。中位连续PIPAC手术为3（1-12）例。10例（6.1%）和5例（3.1%）手术分别发生了总体和重大并发症（CTCAE - III，IV）。2例患者（4.7%）在PIPAC手术后30天内死亡，1例与小肠梗阻相关，另1例与肺栓塞相关。总生存期为19.1个月。6例（14.3%）患者在治疗期间可切除，并接受了根治性CRS和HIPEC.Conclusions：PIPAC与低剂量顺铂和阿霉素联合全身化疗治疗胃PM是安全可行的。生存数据令人鼓舞，并证明在该适应症中进行进一步的临床研究是合理的。(C)2020年爱思唯尔有限公司，BASO -癌症外科协会和欧洲外科肿瘤学会。All rights reserved.
Background: PIPAC is a recent approach with promising results for patients with peritoneal metastasis (PM). We aimed to evaluate survival and postoperative outcome of patients with unresectable PM from gastric origin treated with chemotherapy and PIPAC.Methods: A retrospective analysis of a prospective maintained PIPAC database was queried for all patients diagnosed with unresectable PM from gastric cancer who underwent PIPAC before 2018. PIPAC with Cisplatin 7.5 mg/m2 and doxorubicin 1.5 mg/m2 were given for 30 min at 6-week intervals. Outcome criteria were overall survival and adverse events according to (CTCAE) version4.0.Results: One hundred Sixty-three PIPAC were done in 42 consecutive patients. Twenty-two (52%) of the patients were female. Signet-ring cells were observed in 33/42 patients (78.6%). At the first PIPAC, median age was 51.5 years (32-74). Median PCI was 17 (1-39). Twenty (47.6%) patients underwent more than 2 lines of pre-PIPAC chemotherapy. All patients had systemic chemotherapy alternating with PIPAC. Median consecutive PIPAC procedures were 3 (1-12). Overall and major complications (CTCAE - III, IV) occurred in 10 (6.1%) and 5 procedures (3.1%), respectively. Two patients (4.7%) died within 30 days of a PIPAC procedure, one related to small bowel obstruction and a pulmonary embolism for the other. Overall Survival was 19.1 months. Six (14.3%) patients became resectable during treatment and underwent curative intent CRS and HIPEC.Conclusions: PIPAC with low-dose cisplatin and doxorubicin is safe and feasible in association with systemic chemotherapy for gastric PM. Survival data are encouraging and justify further clinical studies in this indication. (C) 2020 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.