Feldbrügge Linda, Gronau Felix, Brandl Andreas, Auer Timo Alexander, Oeff Alan, Thuss-Patience Peter, Pratschke Johann, Rau Beate
Department of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Digestive Unit, Champalimaud Foundation, Lisbon, Portugal.
Front Oncol. 2021 Apr 12;10:610572. doi: 10.3389/fonc.2020.610572. eCollection 2020.
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a laparoscopic technique for local chemotherapy. It has been used for treatment of peritoneal metastasis of gastric cancer (PM GC) in combination with systemic therapy. VEGFR2 antagonist ramucirumab is a second-line therapy for GC, and has been suspected to cause wound healing disorders.
This is a retrospective single center cohort study of patients with PM GC, who received PIPAC treatment in combination with systemic chemotherapy with and without ramucirumab. Data on patients' characteristics and their perioperative courses were collected and complication rates were compared with regard to preoperative use of ramucirumab and time between last dose of systemic therapy and PIPAC treatment.
Fifty patients underwent 90 PIPAC treatments for PM GC in 3 years. Overall postoperative morbidity was 11% with 6% severe complications. The mean interval between systemic therapy and PIPAC was 20 days. Neither the length of interval nor the use of ramucirumab had an effect on complication rates.
Our study suggests that addition of ramucirumab to pre-PIPAC systemic therapy, irrespective of the length of the treatment-free interval before PIPAC, does not increase the risk of postoperative complications and is therefore a safe option for treatment of PM GC.
腹腔内加压气雾化疗（PIPAC）是一种用于局部化疗的腹腔镜技术。它已与全身治疗联合用于治疗胃癌腹膜转移（PM GC）。血管内皮生长因子受体2（VEGFR2）拮抗剂雷莫西尤单抗是GC的二线治疗药物，且一直被怀疑会导致伤口愈合障碍。
这是一项针对PM GC患者的回顾性单中心队列研究，这些患者接受了PIPAC治疗，并联合或不联合雷莫西尤单抗进行全身化疗。收集患者的特征数据及其围手术期病程，并比较术前使用雷莫西尤单抗以及最后一剂全身治疗与PIPAC治疗之间的时间间隔的并发症发生率。
50例患者在3年内接受了90次针对PM GC的PIPAC治疗。总体术后发病率为11%，严重并发症发生率为6%。全身治疗与PIPAC之间的平均间隔为20天。间隔时间长短和雷莫西尤单抗的使用均未对并发症发生率产生影响。
我们的研究表明，在PIPAC前的全身治疗中添加雷莫西尤单抗，无论PIPAC前无治疗间隔的长短，均不会增加术后并发症的风险，因此是治疗PM GC的安全选择。
