Oh Soohyun, Paik Haerin, Park Soo Jin, Lee Eun Ji, Kim Hee Seung
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Gland Surg. 2021 Mar;10(3):1244-1251. doi: 10.21037/gs-2019-ursoc-12.
For recurrent ovarian, fallopian or primary peritoneal cancer with peritoneal carcinomatosis (PC), it is challenging to resect tumors completely or to get complete remission by intravenous (IV) chemotherapy, and many patients show the resistance to various chemotherapeutic agents for IV chemotherapy ultimately. As an alternative, pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been introduced for treating the disease, which delivers chemotherapeutic agents as an aerosol form while maintaining high intraperitoneal (IP) pressure. Based on preclinical studies, PIPAC showed better penetration depth and distribution of drugs into the peritoneum in comparison to conventional IP chemotherapy. Tumor regression on histology and peritoneal carcinomatosis index (PCI) has also been shown in relevant studies. In addition, most of the PIPAC procedures were completed successfully with acceptable toxicity due to the use of a low dose of chemotherapeutic agents. For considering these advantages of PIPAC, we review the current status of PIPAC for treating recurrent ovarian, fallopian or primary peritoneal cancer through literature review.
对于伴有腹膜癌转移（PC）的复发性卵巢癌、输卵管癌或原发性腹膜癌，要完全切除肿瘤或通过静脉（IV）化疗实现完全缓解具有挑战性，而且许多患者最终会对IV化疗的各种化疗药物产生耐药性。作为一种替代方法，已经引入了加压腹腔内气溶胶化疗（PIPAC）来治疗这种疾病，它在维持高腹腔内（IP）压力的同时以气溶胶形式输送化疗药物。基于临床前研究，与传统的IP化疗相比，PIPAC显示出更好的药物渗透深度和在腹膜内的分布。相关研究中也显示了组织学上的肿瘤消退和腹膜癌转移指数（PCI）。此外，由于使用低剂量的化疗药物，大多数PIPAC手术都成功完成，且毒性可接受。考虑到PIPAC的这些优势，我们通过文献综述来回顾PIPAC治疗复发性卵巢癌、输卵管癌或原发性腹膜癌的现状。
