Abstract
The aim of the study was to analyze the immediate and long-term outcomes of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in gastric cancer patients with peritoneal carcinomatosis (PC). Material and methods . The treatment protocol included diagnostic laparoscopy with PCI score assessment and peritoneal biopsy and 4 courses of systemic chemotherapy with XELOX or FOLFOX followed by PIPAC with cisplatin and doxorubicin at 6–8 week intervals. Between the PIPAC cycles patients received systemic chemotherapy according to previous regimen. Each PIPAC procedure included laparoscopy, evaluation of Peritoneal Carcinomatosis Index (PCI) and peritoneal biopsies. Results . 102 (80.3 %) patients had primary gastric cancer with PC and 25 (19.7 %) had peritoneal recurrence of gastric cancer. PCI 18 in 34 (26.7 %) patients. Diffuse type of cancer was diagnosed in 114 patients (89.7 %), intestinal type in 6 (4.7 %) patients and the mixed type in 7 (5.5 %) patients. 127 patients underwent 310 PIPAC procedures. No severe complications and were observed. Pathological response (PRGC score) was evaluated in 72 patients. Partial pathological response (PRGS 2) was achieved in 40 (55.6 %) cases and complete pathological response (PRGS 1) – in 10 (13.9 %). Survival was evaluated in 63 % (n=80) patients who received more than one PIPAC. The median survival was 16.0 months and one year survival rate was 77.9 %. Conclusion . A new approach to the treatment of gastric cancer with PC combining systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy is a simple and save method allowing improvement of survival of patients with peritoneal dissemination of gastric cancer.
Highlights
РФ преимущественным видом симптоматической терапии пациентам с диссеминированным раком желудка является выполнение повторных лапароцентезов с целью эвакуации асцитической жидкости
The treatment protocol included diagnostic laparoscopy with Peritoneal Carcinomatosis Index (PCI) score assessment and peritoneal biopsy and 4 courses of systemic chemotherapy with XELOX or FOLFOX followed by PIPAC with cisplatin and doxorubicin at 6–8 week intervals
Between the PIPAC cycles patients received systemic chemotherapy according to previous regimen
Summary
Цель исследования – изучить непосредственные и отдалённые результаты применения внутрибрюшной аэрозольной химиотерапии под давлением (ВАХД) у больных с перитонеальным карциноматозом при раке желудка. Каждый сеанс ВАХД включал лапароскопию, повторную биопсию и оценку PCI. У 102 (80,3 %) больных был первичный рак желудка с ПК, у 25 (19,7 %) – перитонеальный рецидив. Диффузный тип рака желудка выявлен у 114 больных (89,7 %), кишечный тип – у 6 (4,7 %), смешанный тип – у 7 (5,5 %). Выживаемость оценена у 63 % (n=80), получивших более 1 сеанса ВАХД. Новый подход к лечению больных раком желудка с перитонеальным карциноматозом, сочетающий системную химиотерапию и внутрибрюшную аэрозольную химиотерапию под давлением, зарекомендовал себя как относительно простой и безопасный метод, позволяющий добиться увеличения общей выживаемости у пациентов с диссеминированным раком желудка. Ключевые слова: рак желудка, перитонеальный карциноматоз, внутрибрюшная аэрозольная химиотерапия под давлением
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
