Falkenstein Thomas A, Götze Thorsten O, Ouaissi Mehdi, Tempfer Clemens B, Giger-Pabst Urs, Demtröder Cédric
Basic Research Laboratories of the Department of Surgery, St. Mary's Hospital, Ruhr University Bochum, Herne, Germany.
Institute of Clinical Cancer Research, UCT-University Cancer Center Frankfurt, Hospital Nordwest, Frankfurt, Germany.
Anticancer Res. 2018 Jan;38(1):373-378. doi: 10.21873/anticanres.12232.
Patients suffering from peritoneal metastasis of biliary tract cancer were treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC).
This was a study carried out at a single institution, tertiary referral center certified for therapy of peritoneal disease. Retrospective data analysis was performed of prospective data for PIPAC with intra-peritoneal low-dose doxorubicin (1.5 mg/m) and cisplatin (7.5 mg/m) delivered at intervals of 6 weeks. The outcome criteria were microscopic pathological response, survival, and adverse events [Common Terminology Criteria of Adverse Events (v4.0)].
A total of 13 patients (male/female=8/5) with a mean age of 58 (range=37-75) years underwent 17 PIPAC procedures without intraoperative complications. The mean number of PIPAC applications was 1.3 (range=0-3). Due to non-accessibility of the abdominal cavity in two patients (15.4%) and rapid clinical deterioration in six patients (46%), five patients underwent two or more PIPAC applications and were, therefore, eligible for histological analysis to assess carcinoma regression. Overall tumor regression of any degree was determined in 4/5 patients. An overall median survival of 85 days (95% confidence interval(CI)=59.2-110.4 days) after the first PIPAC application was observed. No complications greater than Common Terminology Criteria of Adverse Events (v4.0) level 2 occurred.
PIPAC can induce objective regression of systemic chemotherapy-resistant peritoneal metastasis of biliary tract cancer. However, due to a rapid clinical deterioration of the patients, almost two-thirds of the patients cannot undergo repetitive PIPAC courses.
患有胆道癌腹膜转移的患者接受了腹腔加压雾化化疗（PIPAC）。
本研究在一家单一机构进行，该机构是经认证的腹膜疾病治疗三级转诊中心。对前瞻性数据进行回顾性数据分析，这些数据来自接受腹腔内低剂量阿霉素（1.5mg/m）和顺铂（7.5mg/m）、间隔6周给药的PIPAC治疗。结局标准为微观病理反应、生存率和不良事件[不良事件通用术语标准（第4.0版）]。
共有13例患者（男/女=8/5），平均年龄58岁（范围=37 - 75岁）接受了17次PIPAC治疗，无术中并发症。PIPAC应用的平均次数为1.3次（范围=0 - 3次）。由于两名患者（15.4%）腹腔无法进入，六名患者（46%）临床迅速恶化，五名患者接受了两次或更多次PIPAC治疗，因此有资格进行组织学分析以评估癌消退情况。4/5的患者确定有任何程度的总体肿瘤消退。首次PIPAC应用后观察到总体中位生存期为85天（95%置信区间（CI）=59.2 - 110.4天）。未发生大于不良事件通用术语标准（第4.0版）2级的并发症。
PIPAC可诱导对全身化疗耐药的胆道癌腹膜转移出现客观消退。然而，由于患者临床迅速恶化，近三分之二的患者无法接受重复的PIPAC疗程。
