title: Low-dose pressurized intraperitoneal aerosol chemotherapy (PIPAC) as an alternative therapy for ovarian cancer in an octogenarian patient.
abstract: BACKGROUND
  Octogenarians with ovarian cancer limited to the abdomen may not be willing or able to undergo systemic chemotherapy. Low-dose pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin is a form of intra-abdominal chemotherapy which can be applied repeatedly and potentially prevents from the systemic side-effects of chemotherapy.
  
  
  METHODS
  We present the case of an 84-year-old woman with laparoscopically and histologically confirmed ovarian cancer who refused to undergo systemic chemotherapy. She was treated with eight courses q 28-104 days of low-dose PIPAC with cisplatin at 7.5 mg/m(2) and doxorubicin at 1.5 mg/m(2) at 12 mmHg and 37 °C for 30 min. Objective tumor response was noted, defined as tumor regression on histology, and stable disease noted by peritoneal carcinomatosis index on repeated video-laparoscopy and abdominal computed tomographic scan. The treatment was well-tolerated with no Common Terminology Criteria for Adverse Events (CTCAE) CTCAE >2. With a follow-up of 15 months, the patient is alive and clinically stable. The quality of life measured by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 demonstrated improvement over 5-6 months (global physical score, global health score, global quality of live) without cumulative increase of gastrointestinal toxicity.
  
  
  CONCLUSIONS
  Low-dose PIPAC is a new form of intraperitoneal chemotherapy which may be applied repeatedly in octogenarian patients. PIPAC may be an alternative and well-tolerated treatment for selected octogenarian patients with ovarian cancer limited to the abdomen who cannot be treated with systemic chemotherapy.
authors: Department of Surgery, Ruhr University Bochum, Bochum, Germany.
authors: Urs
authors: U
authors: Giger-Pabst
authors: Institute of Pathology, Medical School Hannover, Hannover, Germany.
authors: Wiebke
authors: W
authors: Solass
authors: Department of Obstetrics and Gynecology,Ruhr University Bochum, Bochum, Germany.
authors: Bernd
authors: B
authors: Buerkle
authors: Department of Surgery, Ruhr University Bochum, Bochum, Germany.
authors: Marc-André
authors: MA
authors: Reymond
authors: Department of Obstetrics and Gynecology,Ruhr University Bochum, Bochum, Germany clemens.tempfer@marienhospital-herne.de.
authors: Clemens B
authors: CB
authors: Tempfer
mesh_terms: D000336:Aerosols / Q000008:administration & dosage; D000369:Aged, 80 and over; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010532:Peritoneal Diseases / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life
chemical_list: D000336:Aerosols; D002945:Cisplatin
keywords: Ovarian cancer; adverse effects; antineoplastic agents; high pressure; intraperitoneal chemotherapy; octogenarian; peritoneal carcinomatosis; quality of life