Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France.
Lyon Center for lnnovation in Cancer- EA 3738, Lyon 1 University, Lyon, EA, France.
J Gastrointest Cancer. 2022 Dec;53(4):971-979. doi: 10.1007/s12029-021-00698-8. Epub 2021 Oct 22.
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new surgical technique for the treatment of initially unresectable peritoneal carcinomatosis (PC). Our objective was to compare the results of PIPAC associated with systemic chemotherapy (PIPAC_CHEM) with those of systemic chemotherapy alone (ONLY_CHEM) in patients with gastric PC without metastasis other than peritoneal, and the WHO performance status < 3.
This was a retrospective, single center, comparative non-randomized study. Seventeen PIPAC_CHEM patients were compared to 29 ONLY_CHEM patients. The primary endpoint was overall survival at 6 months from diagnosis of PC.
Ninety-eight patients were screened and 46 were included (PIPAC_CHEM, n = 17; ONLY_CHEM, n = 29). The PIPAC_ CHEM population was significantly younger (median 64 years [56; 68] vs 74 years [61; 79]; p = 0.0054). Median PIPAC session per patient is 2 [1-3]. Six-month survival was significantly higher in the PIPAC_CHEM group than in the ONLY_CHEM group 16/17 (94.1% [65-99.2]) vs 19/29 (65.5% [45.4-79.7]), respectively; p = 0.029. Over the entire follow-up, median survival [95% CI] was 12.8 months [7.2-34.3] with PIPAC vs 9.1 months [5.4-11.5] without, p = 0.056. At 6 months, median length of additional hospitalization was significantly less for PIPAC_CHEM (median 2 days [2-7]) than without PIPAC (median 11 days [3-21]) (p = 0.045).
The overall survival at 6 months after the diagnosis of carcinomatosis was significantly better for PIPAC_CHEM patients. This difference appears to continue until at least 18 months. At 6 months, days of additional hospitalization was significantly less in the PIPAC_CHEM group.
Clinicaltrials.gov Identifier: NCT 04,879,953.
加压腹腔内气溶胶化疗（PIPAC）是一种治疗最初不可切除的腹膜癌病（PC）的新手术技术。我们的目的是比较 PIPAC 联合全身化疗（PIPAC_CHEM）与单纯全身化疗（ONLY_CHEM）在无转移但腹膜以外的胃癌 PC 患者和世界卫生组织表现状态<3 中的结果。
这是一项回顾性、单中心、非随机比较研究。将 17 名 PIPAC_CHEM 患者与 29 名 ONLY_CHEM 患者进行比较。主要终点是从 PC 诊断开始的 6 个月的总生存。
筛选了 98 名患者，其中 46 名入选（PIPAC_CHEM，n=17；ONLY_CHEM，n=29）。PIPAC_CHEM 组明显更年轻（中位数 64 岁[56；68]与 74 岁[61；79]；p=0.0054）。每位患者的中位 PIPAC 治疗次数为 2 次[1-3]。PIPAC_CHEM 组 6 个月生存率明显高于 ONLY_CHEM 组 16/17（94.1%[65-99.2%]与 19/29（65.5%[45.4-79.7]）；p=0.029）。在整个随访期间，PIPAC 组的中位生存时间[95%CI]为 12.8 个月[7.2-34.3]，无 PIPAC 组为 9.1 个月[5.4-11.5]，p=0.056。6 个月时，PIPAC_CHEM 组的额外住院天数明显短于无 PIPAC 组（中位数 2 天[2-7]与中位数 11 天[3-21]）（p=0.045）。
PC 诊断后 6 个月的总生存率在 PIPAC_CHEM 患者中明显更好。这种差异似乎至少持续到 18 个月。在 6 个月时，PIPAC_CHEM 组的额外住院天数明显减少。
Clinicaltrials.gov 标识符：NCT 04879933。
