Background: Since 2011, Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) has emerged as a promising treatment option for patients with peritoneal surface malignancies (PSM) who are not eligible for cytoreductive surgery (CRS). Repeated minimal-invasive treatment is one of the key features and the current empirical standard treatment (ST) consists of at least three administrations over about three months. However, many patients are unable to complete the full course, limiting the potential benefits of PIPAC.Method: This retrospective, single-center study assessed the completion rate of ST and identified the main causes and predictive factors for discontinuation. This study also evaluated the feasibility, safety, and efficacy of PIPAC and investigated whether improved patient selection over the years has resulted in better oncological outcomes.Result: Data from 168 patients treated with PIPAC between January 2017 and March 2023 for a total of 336 procedures showed that only 29% completed ST. Multivariate analysis identified ascites >500 mL and a prior history of bowel obstruction as significant predictors of discontinuation.Conclusions: Patients with radiological or clinical signs of obstruction should not be considered for PIPAC treatment, and ascites increases the risk of incomplete treatment. Larger studies are eagerly awaited to corroborate these findings and refine the selection criteria by disease entity.
背景：自2011年以来，加压腹腔内气溶胶化疗（PIPAC）已成为不适合进行细胞减灭术（CRS）的腹膜表面恶性肿瘤（PSM）患者的一种有前景的治疗选择。重复微创治疗是其关键特征之一，当前的经验性标准治疗（ST）包括在大约三个月内至少进行三次给药。然而，许多患者无法完成整个疗程，这限制了PIPAC的潜在益处。 方法：这项回顾性单中心研究评估了ST的完成率，并确定了中断治疗的主要原因和预测因素。本研究还评估了PIPAC的可行性、安全性和有效性，并探讨了多年来改进的患者选择是否带来了更好的肿瘤学结果。 结果：对2017年1月至2023年3月期间接受PIPAC治疗的168名患者（共336次手术）的数据分析显示，仅有29%的患者完成了ST。多变量分析确定腹水>500 mL和既往肠梗阻史是中断治疗的显著预测因素。 结论：具有影像学或临床梗阻征象的患者不应考虑接受PIPAC治疗，且腹水会增加治疗不完整的风险。我们迫切期待更大规模的研究来证实这些发现，并根据疾病实体完善选择标准。
肿瘤(癌症)患者之家