Tempfer Clemens B
Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
Med Hypotheses. 2015 Oct;85(4):480-4. doi: 10.1016/j.mehy.2015.07.001. Epub 2015 Jul 29.
Peritoneal carcinomatosis (PC) is difficult to treat and many efforts have been made to identify effective and safe treatments. One hypothetical way to increase the efficacy of chemotherapy regarding tumor eradication or tumor control is to apply chemotherapeutic agents into the abdomen in the form of a pressurized aerosol, taking advantage of the physical properties of gas and pressure. This new approach for treatment of PC is based on the assumption that (1) intraabdominal application of chemotherapy under pressure will enhance tumor drug uptake and (2) aerosolizing and spraying chemotherapy will enhance the area of peritoneal surface covered by the drug, (3) resulting in an improved anti-tumor efficacy. Ex vivo and in vitro models have tested this approach and have demonstrated good peritoneal cavity coverage, deep peritoneal drug infiltration, and technical feasibility. Occupational safety of this procedure has also been established. First evidence in humans with peritoneal cancer from ovarian cancer, gastric cancer, colon cancer, appendiceal cancer, and pseudomyxoma peritonei has been obtained suggesting clinical antitumor activity and procedural safety of repeated pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin. We hypothesize that PIPAC can effectively treat PC and will hence become part of the surgical and chemotherapeutical treatment spectrum of this disease in the future.
腹膜癌病（PC）难以治疗，人们已做出诸多努力来寻找有效且安全的治疗方法。提高化疗在肿瘤根除或肿瘤控制方面疗效的一种假设方法是，利用气体和压力的物理特性，以加压气雾剂的形式将化疗药物注入腹腔。这种治疗PC的新方法基于以下假设：（1）在压力下腹腔内应用化疗药物将增强肿瘤对药物的摄取；（2）将化疗药物雾化并喷洒将增加药物覆盖的腹膜表面积；（3）从而提高抗肿瘤疗效。体外和体内模型已对该方法进行了测试，并证明其具有良好的腹腔覆盖、腹膜深层药物渗透以及技术可行性。该操作的职业安全性也已得到证实。已获得来自卵巢癌、胃癌、结肠癌、阑尾癌和腹膜假黏液瘤的腹膜癌患者的初步证据，表明顺铂和阿霉素重复加压腹腔内气雾剂化疗（PIPAC）具有临床抗肿瘤活性和操作安全性。我们假设PIPAC可以有效治疗PC，因此在未来将成为这种疾病手术和化疗治疗方案的一部分。
