一项关于接受腹腔内加压气溶胶化疗（PIPAC）的腹膜转移（PM）患者生活质量（QoL）的系统评价。

A systematic review on quality of life (QoL) of patients with peritoneal metastasis (PM) who underwent pressurized intraperitoneal aerosol chemotherapy (PIPAC).

作者信息

Li Zhenyue, Wong Louis Choon Kit, Sultana Rehena, Lim Hui Jun, Tan Joey Wee-Shan, Tan Qiu Xuan, Wong Jolene Si Min, Chia Claramae Shulyn, Ong Chin-Ann Johnny

机构信息

Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.

Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore.

出版信息

Pleura Peritoneum. 2022 Apr 21;7(2):39-49. doi: 10.1515/pp-2021-0154. eCollection 2022 Jun 1.

BACKGROUND

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has recently emerged as a palliative alternative for patients with unresectable peritoneal metastasis (PM). Quality of life (QoL) has increasingly been used as an endpoint to evaluate treatment outcomes. This review aims to identify evidence on how PIPAC would impact the QoL of PM patients.

CONTENT

A systematic review was performed on articles identified from Medline, EMBASE, PsycInfo, and Web of Sciences. A meta-analysis was conducted on further selected studies. ACROBAT-NRSI was attempted to assess the risk of bias (RoB).

SUMMARY

Nine studies using the EORTC QLQ-C30 questionnaire to assess QoL after repeated PIPAC cycles were identified. Majority was found to be moderately biased and a great extent of heterogeneity was observed. Four studies on PM from either gastric cancer (GC) or epithelial ovarian cancer (EOC) were included for meta-analysis. In 31 GC patients and 104 EOC patients, QoL remained stable in 13/14 and 11/14 EORTC QLQ-C30 scales. PIPAC was inferior to cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in global QoL and functioning but superior in symptom reduction.

OUTLOOK

PIPAC is a well-tolerated option for most GC and EOC patients with irresectable PM. Future trials are warranted to confirm the findings.

背景

腹腔内加压气溶胶化疗（PIPAC）最近已成为不可切除腹膜转移（PM）患者的一种姑息性替代治疗方法。生活质量（QoL）越来越多地被用作评估治疗结果的终点指标。本综述旨在确定关于PIPAC如何影响PM患者生活质量的证据。

内容

对从Medline、EMBASE、PsycInfo和科学网检索到的文章进行了系统综述。对进一步筛选的研究进行了荟萃分析。尝试使用ACROBAT-NRSI评估偏倚风险（RoB）。

总结

共确定了9项使用欧洲癌症研究与治疗组织核心问卷（EORTC QLQ-C30）评估重复PIPAC周期后生活质量的研究。发现大多数研究存在中度偏倚，且观察到很大程度的异质性。纳入了4项关于胃癌（GC）或上皮性卵巢癌（EOC）腹膜转移的研究进行荟萃分析。在31例GC患者和104例EOC患者中，13/14和11/14的EORTC QLQ-C30量表显示生活质量保持稳定。在总体生活质量和功能方面，PIPAC不如细胞减灭术联合热灌注化疗（CRS/HIPEC），但在减轻症状方面更优。