Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) with Low-Dose Cisplatin and Doxorubicin in Gastric Peritoneal Metastasis.
BACKGROUND
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a novel technique of intraperitoneal chemotherapy. First results obtained with PIPAC in patients with advanced peritoneal metastasis (PM) from gastric cancer (GC) are presented.


METHODS
Retrospective analysis: Sixty PIPAC were applied in 24 consecutive patients with PM from GC. 67 % patients had previous surgery, and 79 % previous platinum-based systemic chemotherapy. Mean Peritoneal Carcinomatosis Index (PCI) of 16 ± 10 and 18/24 patients had signet-ring GC. Cisplatin 7.5 mg/m(2) and doxorubicin 1.5 mg/m(2) were given for 30 min at 37 °C and 12 mmHg at 6 week intervals. Outcome criteria were survival, adverse events, and histological tumor response.


RESULTS
Median follow-up was 248 days (range 105-748), and median survival time was 15.4 months. Seventeen patients had repeated PIPAC, and objective tumor response was observed in 12 (12/24 = 50 %): no vital tumor cells = 6, major pathological response = 6, minor response = 3. Postoperative adverse events > CTCAE 2 were observed in 9 patients (9/24, 37.5 %). In 3/17 patients, a later PIPAC could not be performed due to non-access. Two patients (ECOG 3 and 4) died in the hospital due to disease progression.


CONCLUSIONS
PIPAC with low-dose cisplatin and doxorubicin was safe and induced objective tumor regression in selected patients with PM from recurrent, platinum-resistant GC. First survival data are encouraging and justify further clinical studies in this indication.
Department of Surgery, University of Magdeburg, Magdeburg, Germany.
Giorgi
G
Nadiradze
Department of Surgery, Ruhr University Bochum, Bochum, Germany.
Urs
U
Giger-Pabst
Department of Surgery, Ruhr University Bochum, Bochum, Germany.
Juergen
J
Zieren
Department of Internal Medicine, Oncology and Haematology, Ruhr University Bochum, Bochum, Germany.
Dirk
D
Strumberg
Institute of Pathology, Medical School Hanover, Hanover, Germany.
Wiebke
W
Solass
Department of Surgery, University of Magdeburg, Magdeburg, Germany. marcandre.reymond@elisabethgruppe.de.|Department of Surgery, Ruhr University Bochum, Bochum, Germany. marcandre.reymond@elisabethgruppe.de.|Marienhospital Herne, Ruhr University Bochum, Hölkeskampring 40, 44625, Herne, Germany. marcandre.reymond@elisabethgruppe.de.
Marc-André
MA
Reymond
D000328:Adult; D000336:Aerosols; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002277:Carcinoma / Q000188:drug therapy* / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage*; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology*
D000336:Aerosols; D000970:Antineoplastic Agents; D004317:Doxorubicin; D002945:Cisplatin
Cisplatin; Doxorubicin; Gastric cancer; Intraperitoneal chemotherapy; Peritoneal metastasis; Pressurized intraperitoneal aerosol chemotherapy