Introduction: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) consists of the administration of aerosolized chemotherapy into the abdominal cavity of patients suffering from peritoneal carcinomatosis. Our aim was to review the evidence supporting PIPAC in patients with peritoneal carcinomatosis from colorectal cancer. Methods: A systematic review was performed in accordance with the 2020 PRISMA guideline. MEDLINE and CENTRAL were searched using combinations of terms including “Peritoneal carcinomatosis”, “Peritoneal metastasis”, “PIPAC”, “Pressurized intraperitoneal aerosol chemotherapy” and “Colorectal cancer”. Original studies, in English, including patients treated with PIPAC for colorectal peritoneal carcinomatosis, were considered eligible. Case reports, non-English or French language articles and secondary analyses were excluded. Results: A total of 385 articles were screened and 374 articles were excluded, leaving 11 publications for inclusion in the qualitative analysis. The included studies totalized 949 patients who received PIPAC for peritoneal carcinomatosis due to colorectal cancer. The median peritoneal carcinomatosis index (PCI) ranged from 10 to 31. In all studies, the complete PIPAC protocol was achieved with an average of two to three 3 PIPAC sessions per patient. Oxaliplatin (OX) was used as a chemotherapeutic agent in all studies and could be associated with intravenous 5-FU and leucovorin. Most post-operative adverse events were recorded as mild to moderate with no intraoperative complications. Only four studies reported a decrease in the average PCI score for 50% of the patients. Median overall survival ranged from 8 to 37.8 months. Quality of life indicators were stable between PIPAC-OX cycles with a small but not statistically significant trend of improvement of most functional scales. Conclusions: PIPAC for peritoneal carcinomatosis from colorectal origin is feasible, safe and tolerable. Its impact on survival outcomes or quality of life remains to be demonstrated by randomized trials.
引言：加压腹腔内气溶胶化疗（PIPAC）是将气溶胶化化疗药物注入腹膜癌病患者腹腔的治疗方法。本研究旨在系统回顾支持PIPAC治疗结直肠癌源性腹膜癌病的循证依据。方法：根据2020年PRISMA指南进行系统综述，通过组合检索词"腹膜癌病"、"腹膜转移"、"PIPAC"、"加压腹腔内气溶胶化疗"及"结直肠癌"在MEDLINE和CENTRAL数据库进行检索。纳入标准为包含结直肠癌腹膜转移患者接受PIPAC治疗的英文原创研究，排除病例报告、非法语/英语文献及二次分析研究。结果：共筛查385篇文献，排除374篇，最终11篇纳入定性分析。纳入研究累计949例结直肠癌源性腹膜癌病患者接受PIPAC治疗，腹膜癌病指数中位值范围为10-31。所有研究均完成完整PIPAC方案，患者平均接受2-3次治疗。所有研究均使用奥沙利铂作为化疗药物，部分联合静脉注射5-氟尿嘧啶及亚叶酸钙。术后不良事件多为轻中度，无术中并发症报道。仅4项研究报道50%患者平均PCI评分降低，中位总生存期为8-37.8个月。生活质量指标在PIPAC-OX周期间保持稳定，多数功能量表呈小幅改善趋势但无统计学意义。结论：PIPAC治疗结直肠癌源性腹膜癌病具有可行性、安全性和耐受性，其对生存结局及生活质量的影响仍需随机试验验证。
肿瘤(癌症)患者之家