First Clinical Data of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) as Salvage Therapy for Peritoneal Metastatic Biliary Tract Cancer.

Abstract

BACKGROUND:

Patients suffering from peritoneal metastasis of biliary tract cancer were treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC).

PATIENTS AND METHODS:

This was a study carried out at a single institution, tertiary referral center certified for therapy of peritoneal disease. Retrospective data analysis was performed of prospective data for PIPAC with intra-peritoneal low-dose doxorubicin (1.5 mg/m2) and cisplatin (7.5 mg/m2) delivered at intervals of 6 weeks. The outcome criteria were microscopic pathological response, survival, and adverse events [Common Terminology Criteria of Adverse Events (v4.0)].

RESULTS:

A total of 13 patients (male/female=8/5) with a mean age of 58 (range=37-75) years underwent 17 PIPAC procedures without intraoperative complications. The mean number of PIPAC applications was 1.3 (range=0-3). Due to non-accessibility of the abdominal cavity in two patients (15.4%) and rapid clinical deterioration in six patients (46%), five patients underwent two or more PIPAC applications and were, therefore, eligible for histological analysis to assess carcinoma regression. Overall tumor regression of any degree was determined in 4/5 patients. An overall median survival of 85 days (95% confidence interval(CI)=59.2-110.4 days) after the first PIPAC application was observed. No complications greater than Common Terminology Criteria of Adverse Events (v4.0) level 2 occurred.

CONCLUSION:

PIPAC can induce objective regression of systemic chemotherapy-resistant peritoneal metastasis of biliary tract cancer. However, due to a rapid clinical deterioration of the patients, almost two-thirds of the patients cannot undergo repetitive PIPAC courses.

• Authors: Thomas A Falkenstein, Thorsten O Götze, Mehdi Ouaissi, Clemens B Tempfer, Urs Giger-Pabst, Cédric Demtröder
• Journal: Anticancer research (Anticancer Res) Vol. 38 Issue 1 Pg. 373-378 (01 2018) ISSN: 1791-7530 [Electronic] Greece
• PMID: 29277797 (Publication Type: Journal Article)
• Copyright: Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Chemical References

• Antibiotics, Antineoplastic
• Doxorubicin
• Cisplatin

Topics

• Adult
• Aged
• Antibiotics, Antineoplastic (therapeutic use)
• Biliary Tract Neoplasms (drug therapy, pathology)
• Cisplatin (therapeutic use)
• Doxorubicin (therapeutic use)
• Female
• Humans
• Infusions, Parenteral (methods)
• Male
• Middle Aged
• Peritoneal Neoplasms (drug therapy, mortality, secondary)
• Peritoneum (pathology)
• Retrospective Studies
• Salvage Therapy (methods)