Department of Surgery, Catharina Hospital, Catharina Cancer Institute, PO Box 1350, 5602 ZA, Eindhoven, The Netherlands.
Department of Research, Netherlands Cancer Registry, IKNL, Utrecht, The Netherlands.
Sci Rep. 2023 Nov 22;13(1):20458. doi: 10.1038/s41598-023-47510-0.
Oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (PIPAC-OX) is an emerging palliative treatment for patients with unresectable colorectal peritoneal metastases. Previously, our study group reported that patients experienced abdominal pain for several weeks after PIPAC-OX. However, it is unknown how this compares to abdominal pain after regular colorectal cancer surgery. To provide some perspective, this study compared the presence of abdominal pain after PIPAC-OX to the presence of abdominal pain after primary tumor surgery. Patient reported abdominal pain scores (EORTC QLQ-CR-29), from two prospective, Dutch cohorts were used in this study. Scores ranged from 0 to 100, a higher score represents more abdominal pain. Abdominal pain at baseline and at four weeks after treatment were compared between the two groups. Twenty patients who underwent PIPAC-OX and 322 patients who underwent primary tumor surgery were included in the analysis. At baseline, there were no differences in abdominal pain between both groups (mean 20 vs. 18, respectively; p = 0.688). Four weeks after treatment, abdominal pain was significantly worse in the PIPAC group (39 vs 15, respectively; p < 0.001; Cohen's d = 0.99). The differential effect over time for abdominal pain differed significantly between both groups (mean difference: 19 vs - 3, respectively; p = 0.004; Cohen's d = 0.88). PIPAC-OX resulted in significantly worse postoperative abdominal pain than primary tumor surgery. These results can be used for patient counseling and stress the need for adequate analgesia during and after PIPAC-OX. Further research is required to prevent or reduce abdominal pain after PIPAC-OX.Trial registration CRC-PIPAC: Clinicaltrails.gov NCT03246321 (01-10-2017).
奥沙利铂腹腔内压力喷雾化疗（PIPAC-OX）是一种治疗无法切除的结直肠腹膜转移的新兴姑息治疗方法。此前，我们的研究小组报告称，患者在接受 PIPAC-OX 后会经历数周的腹痛。然而，目前尚不清楚这种情况与常规结直肠癌手术后的腹痛相比如何。为了提供一些参考，本研究比较了 PIPAC-OX 后和原发肿瘤手术后的腹痛情况。本研究使用了两个前瞻性荷兰队列的患者报告的腹痛评分（EORTC QLQ-CR-29）。评分范围从 0 到 100，评分越高表示腹痛越严重。比较了两组患者在基线和治疗后 4 周的腹痛评分。共纳入 20 例接受 PIPAC-OX 治疗的患者和 322 例接受原发肿瘤手术的患者。在基线时，两组患者的腹痛无差异（平均分别为 20 分和 18 分；p=0.688）。治疗后 4 周，PIPAC 组的腹痛明显更严重（分别为 39 分和 15 分；p<0.001；Cohen's d=0.99）。两组患者的腹痛随时间的差异有统计学意义（平均差值：19 分与-3 分；p=0.004；Cohen's d=0.88）。PIPAC-OX 术后腹痛明显比原发肿瘤手术更严重。这些结果可用于患者咨询，并强调在 PIPAC-OX 期间和之后需要充分的镇痛。需要进一步研究以预防或减轻 PIPAC-OX 后的腹痛。
试验注册
CRC-PIPAC：Clinicaltrails.gov NCT03246321（2017 年 10 月 1 日）。
