From palliation to cure: PIPAC for peritoneal malignancies

Fabio Pacelli, Andrea Di Giorgio, Carlo Abatini, Miriam Attalla El Halabieh, Emanuele Vita, Giuseppe Vizzielli, Valerio Gallotta, S Rotolo

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

INTRODUCTION: Systemic chemotherapy offers poor control over peritoneal disease, maybe as a consequence of restricted drug availability within the abdominal cavity. Locoregional chemotherapy may overcome these shortcomings but its administration is limited to a few patients with confined peritoneal spread. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) emerged in the last years as a novel method of intraperitoneal drug administration.EVIDENCE ACQUISITION: We report a meta-analysis of published studies on PIPAC safety and pathological anti-tumoral efficacy on PC from various tumor entities, with the aim of providing more evidence to support further research. This systematic review and meta-analysis were designed, conducted and reported according to the PRISMA statement.EVIDENCE SYNTHESIS: An overall pathological response rate of 43.7% was calculated on a total of 668 patients who underwent 1480 PIPAC cycles across the 20 studies. Pooled severe adverse events rate (CTCAE grade 3-4) was 10% and seven deaths across all studies were reported, of which only four were related to PIPAC.CONCLUSIONS: PIPAC is a safe procedure which has a relevant anti-tumoral activity on peritoneal carcinomatosis. Further studies, even in the early stage of disease, are awaited to assess the clinical benefit of PIPAC. This review may serve as a reliable basis for future research.
Original languageEnglish
Pages (from-to)385-398
Number of pages14
JournalMinerva Medica
Volume110
Publication statusPublished - 2019

Keywords

  • Drug therapy
  • Palliative care
  • Peritoneal neoplasms

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