Background: Peritoneal metastases (PM) of gastric cancer (GC) are considered a terminal condition, with reported median survival ranging from 2 to 9 months. Standard treatment typically involves systemic chemotherapy alone or combined with targeted therapy or immunotherapy, though efficacy is limited. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a novel technique for treating GC PM, although it remains an experimental treatment under investigation. This study aimed to summarize the outcomes of GC PM treatment with PIPAC from the Lithuanian PIPAC program. Methods: All patients who underwent PIPAC for GC PM at Vilnius University Hospital Santaros Klinikos between 2015 and 2022 were included in this retrospective study. The safety of PIPAC was assessed by postoperative complications according to the Clavien–Dindo classification. Efficacy was evaluated based on the peritoneal carcinomatosis index (PCI), ascites dynamics throughout the treatment, and long-term outcomes. Results: In total, 32 patients underwent 71 PIPAC procedures. Intraoperative and postoperative morbidity related to PIPAC occurred after three (4.2%) procedures. Following PIPAC, there was a tendency towards a decrease in median PCI from 10 (Q1 3; Q3 13) to 7 (Q1 2; Q3 12),p= 0.75, and a decrease in median ascites volume from 1300 mL (Q1 500; Q3 3600) at the first PIPAC to 700 mL (Q1 250; Q3 4750) at the last PIPAC,p= 0.56; however, these differences were not statistically significant. The median overall survival after PM diagnosis was 12.5 months (95% CI 10–17), and the median survival after the first PIPAC procedure was 5 months (95% CI 4–10). Conclusions: PIPAC is a safe and feasible treatment option for GC PM; however, well-designed prospective studies are needed to fully assess its efficacy.
背景：胃癌腹膜转移被视为终末状态，报道中位生存期仅为2至9个月。标准治疗方案通常为单纯全身化疗或联合靶向治疗、免疫治疗，但疗效有限。腹腔加压气溶胶化疗作为一种治疗胃癌腹膜转移的新兴技术，目前仍处于研究性治疗阶段。本研究旨在总结立陶宛腹腔加压气溶胶化疗项目中胃癌腹膜转移患者的治疗结果。方法：本研究回顾性纳入2015年至2022年间在维尔纽斯大学医院Santaros Klinikos中心接受腹腔加压气溶胶化疗的所有胃癌腹膜转移患者。根据Clavien-Dindo分级标准评估术后并发症以确定治疗安全性。疗效评估基于腹膜癌指数、治疗期间腹水动态变化及长期预后指标。结果：共32例患者接受71次腹腔加压气溶胶化疗。3次（4.2%）治疗发生术中及术后相关并发症。治疗后观察到中位腹膜癌指数从10（四分位距3-13）降至7（四分位距2-12）（p=0.75），中位腹水量从首次治疗的1300毫升（四分位距500-3600）降至末次治疗的700毫升（四分位距250-4750）（p=0.56），但差异均无统计学意义。腹膜转移确诊后中位总生存期为12.5个月（95%置信区间10-17），首次腹腔加压气溶胶化疗后中位生存期为5个月（95%置信区间4-10）。结论：腹腔加压气溶胶化疗是治疗胃癌腹膜转移安全可行的选择，但其疗效评估仍需通过精心设计的前瞻性研究予以验证。
肿瘤(癌症)患者之家