Guel-Klein Safak, Alberto Vilchez Miguel Enrique, Ceelen Wim, Rau Beate, Brandl Andreas
Department of Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Department of GI Surgery, Ghent University Hospital, Ghent, Belgium.
Visc Med. 2022 Apr;38(2):90-98. doi: 10.1159/000523901. Epub 2022 Mar 21.
The survival prognosis of patients with peritoneal metastasis (PM) of gastrointestinal (GI) cancer is generally poor and treatment consists of, according to international guidelines, systemic chemotherapy. A multimodal treatment approach, including cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy, not only proved to be beneficial mainly in colorectal cancer, but also in selected patients with gastric cancer. The authors performed systematic research of articles and ongoing clinical trials using the keywords "PIPAC" and "gastric cancer" or "colorectal cancer" in PubMed in October 2021. Key findings, such as complications rates, treatment protocols, and overall survival were summarized and illustrated in Tables and critically discussed.
Twenty years ago, the technique of Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) was developed by Reymond et al. and delivered evidence to be recognized as a basic therapeutic tool in this multimodal therapy. Currently, there are several ongoing Phase II and III trials exploring the usage and efficacy of PIPAC as a neoadjuvant, adjuvant, or palliative component of treatment in patients with PM of GI cancer.
The aim of this narrative review was to help navigate the reader throughout the most current evidence for the use PIPAC and to highlight its indication in patients with upper and lower GI cancer with PM. It also provides an outline of ongoing studies and future perspectives.
胃肠道癌腹膜转移（PM）患者的生存预后通常较差，根据国际指南，治疗方法为全身化疗。多模式治疗方法，包括减瘤手术联合或不联合腹腔内热化疗，不仅已证明主要对结直肠癌有益，对部分胃癌患者也有益。作者于2021年10月在PubMed中使用关键词“PIPAC”和“胃癌”或“结直肠癌”对文章和正在进行的临床试验进行了系统研究。关键发现，如并发症发生率、治疗方案和总生存率等，在表格中进行了总结和说明，并进行了批判性讨论。
20年前，雷蒙德等人开发了加压腹腔内气溶胶化疗（PIPAC）技术，并提供了证据使其被认可为这种多模式治疗中的一种基本治疗工具。目前，有几项正在进行的II期和III期试验正在探索PIPAC作为胃肠道癌腹膜转移患者新辅助、辅助或姑息治疗组成部分的用法和疗效。
本叙述性综述的目的是帮助读者梳理关于使用PIPAC的最新证据，并强调其在上下胃肠道癌腹膜转移患者中的适应证。它还提供了正在进行的研究概述和未来展望。
