Intraperitoneal Chemotherapy of Peritoneal Carcinomatosis Using Pressurized Aerosol as an Alternative to Liquid Solution: First Evidence for EfficacyReport as inadecuate




Intraperitoneal Chemotherapy of Peritoneal Carcinomatosis Using Pressurized Aerosol as an Alternative to Liquid Solution: First Evidence for Efficacy - Download this document for free, or read online. Document in PDF available to download.

Annals of Surgical Oncology

, Volume 21, Issue 2, pp 553–559

First Online: 05 September 2013Received: 23 April 2013DOI: 10.1245-s10434-013-3213-1

Cite this article as: Solass, W., Kerb, R., Mürdter, T. et al. Ann Surg Oncol 2014 21: 553. doi:10.1245-s10434-013-3213-1

Abstract

BackgroundPeritoneal carcinomatosis PC is an unmet medical need. Despite recent improvements, systemic chemotherapy has limited efficacy. We report the first application of intraperitoneal chemotherapy as a pressurized aerosol in human patients.

MethodsThree end-stage patients with advanced PC from gastric, appendiceal, and ovarian origin were treated as a compassionate therapy. All patients had received previous systemic chemotherapy. A pressurized aerosol of CO2 loaded with doxorubicin 1.5 mg-m and cisplatin 7.5 mg-m pressurized intraperitoneal aerosol chemotherapy, PIPAC was applied into the abdomen for 30 min at a pressure of 12 mmHg and a temperature of 37 °C.

ResultsNo side-effects >2 CTCAE were observed, and the procedures were well tolerated. Early hospital discharge was possible days 2–5. Nuclear presence of doxorubicin was documented throughout the peritoneum, reaching high local concentration ≤4.1 μmol-g and plasma concentration was low 4.0–6.2 ng-ml. PIPAC created no significant adhesions, could be repeated, and was applied 6×, 4×, and 2×. Two patients showed a complete and one a partial histological remission. Mean survival after the first PIPAC was 288 days. One patient is alive after 567 days.

ConclusionsPIPAC shows superior pharmacological properties with high local concentration and low systemic exposure. PIPAC can induce regression of PC in chemoresistant tumors, using 10 % of a usual systemic dose.

Electronic supplementary materialThe online version of this article doi:10.1245-s10434-013-3213-1 contains supplementary material, which is available to authorized users.

Download fulltext PDF



Author: Wiebke Solass - Reinhold Kerb - Thomas Mürdter - Urs Giger-Pabst - Dirk Strumberg - Clemens Tempfer - Jürgen Zieren - Mat

Source: https://link.springer.com/







Related documents