腹腔内加压气溶胶化疗 (PIPAC) 治疗胃癌伴腹膜转移：PIPAC UK 协作组的系统评价。
Pressurised intraperitoneal aerosolised chemotherapy (PIPAC) for gastric cancer with peritoneal metastases: A systematic review by the PIPAC UK collaborative.
机构信息
South West Wales Cancer Centre, Singleton Hospital, Sketty Lane, Swansea SA2 8QA, UK; Swansea University Medical School, Grove Building, Singleton Park, SA2 8PP, UK.
South West Wales Cancer Centre, Singleton Hospital, Sketty Lane, Swansea SA2 8QA, UK.
出版信息
Crit Rev Oncol Hematol. 2022 Dec;180:103846. doi: 10.1016/j.critrevonc.2022.103846. Epub 2022 Oct 15.
INTRODUCTION
Gastric cancer with peritoneal metastases (GCPM) carries a poor prognosis. Pressurised Intraperitoneal Aerosolised Chemotherapy (PIPAC) offers pharmacokinetic advantages over intravenous therapy, resulting in higher chemotherapy concentrations in peritoneal deposits, and potentially reduced systemic absorption/toxicity. This review evaluates efficacy, tolerability and impact on quality of life (QOL) of PIPAC for GCPM.
METHODS
Following registration with PROSPERO (CRD42021281500), MEDLINE, EMBASE and The Cochrane Library were searched for PIPAC in patients with peritoneal metastases, in accordance with PRISMA standards RESULTS: Across 18 included reports representing 751 patients with GCPM (4 prospective, 11 retrospective, 3 abstracts, no phase III studies), median overall survival (mOS) was 8 - 19.1 months, 1-year OS 49.8-77.9%, complete response (PRGS1) 0-35% and partial response (PRGS2/3) 0-83.3%. Grade 3 and 4 toxicity was 0.7-25% and 0-4.1% respectively. Three studies assessing QOL reported no significant difference.
CONCLUSION
PIPAC may offer promising survival benefits, toxicity, and QOL for GCPM.
简介
胃癌伴腹膜转移（GCPM）预后不良。与静脉治疗相比，加压腹腔内气溶胶化疗（PIPAC）具有药代动力学优势，导致腹膜沉积物中的化疗浓度更高，潜在地降低了全身吸收/毒性。本综述评估了 PIPAC 治疗 GCPM 的疗效、耐受性和对生活质量（QOL）的影响。
方法
根据 PRISMA 标准，在 PROSPERO（CRD42021281500）注册后，对腹膜转移患者的 PIPAC 进行了 MEDLINE、EMBASE 和 The Cochrane Library 的检索。
结果
在纳入的 18 项报告中，代表了 751 例 GCPM 患者（4 项前瞻性研究、11 项回顾性研究、3 项摘要，无 III 期研究），中位总生存期（mOS）为 8-19.1 个月，1 年 OS 为 49.8-77.9%，完全缓解（PRGS1）为 0-35%，部分缓解（PRGS2/3）为 0-83.3%。3 级和 4 级毒性分别为 0.7-25%和 0-4.1%。三项评估 QOL 的研究报告无显著差异。
结论
PIPAC 可能为 GCPM 提供有希望的生存获益、毒性和 QOL。
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