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

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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.

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Authors and Affiliations

  1. Odense PIPAC Center, Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense, Denmark

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

  2. Department of Surgery, Upper GI and HPB Section, Odense University Hospital, Odense, Denmark

    S. Bremholm Ellebæk, M. Graversen, C. W. Fristrup & M. B. Mortensen

  3. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

    M. Graversen, S. Detlefsen, P. Pfeiffer & M. B. Mortensen

  4. OPEN, Open Patient Data Explorative Network, Odense, Denmark

    M. Graversen & M. B. Mortensen

  5. Department of Pathology, Odense University Hospital, Odense, Denmark

    S. Detlefsen

  6. Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden

    L. Lundell

  7. Department of Oncology, Odense University Hospital, Odense, Denmark

    P. Pfeiffer

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  1. S. Bremholm Ellebæk
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  2. M. Graversen
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  7. M. B. Mortensen
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Correspondence to S. Bremholm Ellebæk.

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Ellebæk, S.B., Graversen, M., Detlefsen, S. et al. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) of peritoneal metastasis from gastric cancer: a descriptive cohort study. Clin Exp Metastasis 37, 325–332 (2020). https://doi.org/10.1007/s10585-020-10023-5

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  • DOI: https://doi.org/10.1007/s10585-020-10023-5

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