Background: PIPAC is an innovative treatment that delivers low-dose aerosolized chemotherapy into the abdominal cavity of patients with peritoneal surface malignancies (PSMs). However, its role in the multimodal management of PSMs is unclear.Methods: We retrospectively analyzed data from 64 patients who underwent PIPAC for PSMs of a primary or secondary origin between June 2020 and December 2024 (median age of 64 years). Primary tumor sites included gastric (42.2%), colorectal (23.4%), ovarian cancer (21.9%), and others (12.5%). The median PCI was 15 (IQR 9–25), with ascites present in 60.9% of cases and a positive cytology in 48.4%.Results: A total of 82 PIPAC sessions were performed in 64 patients. The mean operation time was 96 min. Severe adverse events, defined as the Common Terminology Criteria for Adverse Events (CTCAE) of a grade ≥ 2, occurred in four patients (6.2%). The median hospital stay was 3 days, and systemic chemotherapy was resumed within 14 days after the procedure in 27 patients. Among the entire cohort, 37.5% received bidirectional therapy and 62.5% received palliative treatment, with a lower peritoneal cancer index (PCI) in the bidirectional group (9.5 vs. 23). The median overall survival (OS) was 32 months from diagnosis. Sixteen patients (25%) underwent two or more PIPAC sessions and showed an advantage in survival compared to patients who underwent only one procedure (3-year OS: 63.2% vs. 38.4%,p0.030). Conversion surgery was achieved in 34.4%. Patients treated with a bidirectional intent demonstrated a longer OS (3-year: 66.0% vs. 33.9%,p0.011). Colorectal and ovarian tumors exhibited better long-term outcomes compared to gastric cancer.Conclusions: PIPAC is a promising treatment for PSMs, with a low morbidity rate. Its favorable safety and short interval to systemic therapy resumption support its use as part of a bidirectional strategy.
背景：腹腔内加压气溶胶化疗（PIPAC）是一种创新疗法，通过气溶胶形式将低剂量化疗药物输送至腹膜表面恶性肿瘤（PSMs）患者的腹腔。然而，其在PSMs多模式治疗中的作用尚不明确。 方法：我们回顾性分析了2020年6月至2024年12月期间接受PIPAC治疗的64例原发或继发性PSMs患者数据（中位年龄64岁）。原发肿瘤部位包括胃癌（42.2%）、结直肠癌（23.4%）、卵巢癌（21.9%）及其他（12.5%）。中位腹膜癌指数（PCI）为15（四分位距9-25），60.9%的患者存在腹水，48.4%的病例细胞学检测呈阳性。 结果：64例患者共接受82次PIPAC治疗。平均手术时间为96分钟。4例患者（6.2%）发生严重不良事件（定义为不良事件通用术语标准≥2级）。中位住院时间为3天，27例患者在术后14天内恢复了全身化疗。全队列中，37.5%接受双向治疗，62.5%接受姑息治疗，其中双向治疗组的腹膜癌指数（PCI）较低（9.5 vs. 23）。从诊断起计算的中位总生存期（OS）为32个月。16例患者（25%）接受了两次及以上PIPAC治疗，与仅接受一次治疗的患者相比显示出生存优势（3年OS：63.2% vs. 38.4%，p=0.030）。34.4%的患者实现了转化手术。接受双向治疗意向的患者表现出更长的总生存期（3年OS：66.0% vs. 33.9%，p=0.011）。与胃癌相比，结直肠癌和卵巢肿瘤展现出更好的长期预后。 结论：PIPAC是治疗PSMs的一种前景良好的疗法，具有较低的并发症发生率。其良好的安全性及较短的全身治疗恢复间隔，支持其作为双向治疗策略的组成部分。
肿瘤(癌症)患者之家