Khosrawipour Tanja, Khosrawipour Veria, Giger-Pabst Urs
Department of General Surgery & Therapy Center for Peritoneal carcinomatosis, St. Mary's Hospital Herne, Ruhr University Bochum, Bochum, Germany.
Basic Research Laboratories of the Department of Surgery, St. Mary's Hospital Herne, Ruhr-University Bochum, Bochum, Germany.
PLoS One. 2017 Oct 19;12(10):e0186709. doi: 10.1371/journal.pone.0186709. eCollection 2017.
Patients suffering from peritoneal carcinomatosis of pancreatic adenocarcinoma were treated with Pressurized Intra Peritoneal Aerosol Chemotherapy (PIPAC), initial clinical findings are presented.
Single institution, tertiary referral center certified for therapy of peritoneal disease. Prospective data collection of PIPAC therapy with doxorubicin 1.5 mg/m2 and cisplatin 7.5 mg/m2 of body surface delivered at intervals of six weeks. The outcome criteria were microscopic pathological response, survival and adverse events (v4.0 CTCAE).
A total of 20 patients (m/f = 3:1) with a mean age of 64.9 (range: 45.0 to 87.0) years underwent 41 PIPAC procedures without intraoperative complications. The mean number of PIPAC cycles was 2.1 (range: one to four). Ten patients with ≥ 2 PIPAC applications were eligible for histological analysis to assess carcinoma regression. Complete or high grade tumor regression was found in two (10%) and five (25%) patients, respectively. An overall median survival of 36.6 weeks after the first PIPAC application was observed. One patient died postoperatively due to small bowel obstruction. No CTCAE level 3 and 4 complications occurred.
In about one third of patients, repeated PIPAC therapy did induce histological regression of systemic chemo-resistant PC of pancreatic adenocarcinoma. Prospective randomized trials are needed to further clarify any clinical impact of such observations.
对患有胰腺腺癌腹膜转移癌的患者采用腹腔加压气雾剂化疗（PIPAC）进行治疗，并展示了初步临床结果。
单一机构，一家经认证可治疗腹膜疾病的三级转诊中心。前瞻性收集使用阿霉素1.5mg/m²和顺铂7.5mg/m²进行PIPAC治疗的数据，每六周进行一次，治疗面积为体表面积。观察指标为微观病理反应、生存率和不良事件（v4.0版美国国立癌症研究所常见不良反应事件分级标准）。
共有20例患者（男/女 = 3:1），平均年龄64.9岁（范围：45.0至87.0岁），接受了41次PIPAC治疗，术中无并发症。PIPAC治疗周期的平均数为2.1（范围：1至4）。10例接受≥2次PIPAC治疗的患者符合组织学分析条件，以评估癌消退情况。分别在2例（10%）和5例（25%）患者中发现完全或高级别肿瘤消退。首次PIPAC治疗后观察到总体中位生存期为36.6周。1例患者术后因小肠梗阻死亡。未发生3级和4级美国国立癌症研究所常见不良反应事件分级标准并发症。
在约三分之一的患者中，重复PIPAC治疗确实可诱导胰腺腺癌全身化疗耐药性腹膜转移癌的组织学消退。需要进行前瞻性随机试验以进一步阐明这些观察结果的任何临床影响。
