Graversen Martin, Detlefsen Sönke, Bjerregaard Jon Kroll, Pfeiffer Per, Mortensen Michael Bau
Upper GI and HPB Section, Department of Surgery, Odense Patient Explorative Network (OPEN), Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense, Denmark.
Department of Pathology, Odense University Hospital, Odense, Denmark.
Clin Exp Metastasis. 2017 Jun;34(5):309-314. doi: 10.1007/s10585-017-9849-7. Epub 2017 May 17.
Patients with peritoneal metastasis (PM) from pancreatic cancer have a short life expectancy. Systemic combination chemotherapy leads to a median overall survival of 7-8 months. Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) is a treatment alternative, where studies in patients with PM from ovarian, gastric and colorectal cancer show a high safety profile and interesting results. This case study report data on the PIPAC treatment in patients with PM from pancreatic cancer. In a standard laparoscopy, chemotherapeutics (cisplatin and doxorubicin) are nebulized within the peritoneal cavity. After 30 min, the chemotherapeutics are evacuated through a closed system. The PIPAC procedure is repeated every 4-6 weeks. Five patients with PM from pancreatic cancer were treated with a total of 16 PIPAC procedures. All patients received >1 PIPAC and were eligible for evaluation of histological regression. Four patients demonstrated histological regression, and one patient had stable disease. Three patients are still alive, and the median overall survival is 14 months (range 10-20) since the diagnosis of PM. The histological regression and survival figures in this pilot study suggest activity of PIPAC with low-dose cisplatin and doxorubicin in pretreated peritoneal metastasis of pancreatic origin. This should now be evaluated in prospective studies.
胰腺癌腹膜转移（PM）患者的预期寿命较短。全身联合化疗导致的中位总生存期为7 - 8个月。腹腔加压气雾剂化疗（PIPAC）是一种治疗选择，在卵巢癌、胃癌和结直肠癌腹膜转移患者中的研究显示出较高的安全性和有趣的结果。本病例研究报告了胰腺癌腹膜转移患者PIPAC治疗的数据。在标准腹腔镜检查中，化疗药物（顺铂和阿霉素）在腹腔内雾化。30分钟后，化疗药物通过封闭系统排出。PIPAC程序每4 - 6周重复一次。五名胰腺癌腹膜转移患者共接受了16次PIPAC治疗。所有患者均接受了>1次PIPAC治疗，并有资格评估组织学消退情况。四名患者表现出组织学消退，一名患者病情稳定。三名患者仍然存活，自诊断腹膜转移以来的中位总生存期为14个月（范围10 - 20个月）。这项初步研究中的组织学消退和生存数据表明，低剂量顺铂和阿霉素的PIPAC对先前治疗过的胰腺源性腹膜转移有活性。现在应该在前瞻性研究中进行评估。
