PDF(Pubmed)
Abstract：
Taxanes have a favorable pharmacokinetic profile for intraperitoneal application. We report our initial experience with taxane-PIPAC (pressurized intraperitoneal chemotherapy) for unresectable peritoneal metastases from different primary sites in terms of safety, feasibility, response rate, and conversion to resectability. In this retrospective study, PIPAC was performed alone or in combination with systemic chemotherapy. Paclitaxel was used as a single agent, whereas docetaxel was used in combination with cisplatin-adriamycin or oxaliplatin-adriamycin. From December 2019 to December 2021, 47 patients underwent 82 PIPAC procedures (1 PIPAC in 55.3%, 2 in 29.7%, 3 in 14.8%). The most common primary sites were ovarian cancer (31.9%), gastric cancer (23.4%), and colorectal cancer (21.2%). Docetaxel-cisplatin-adriamycin was used in 33 (70.2%) patients, docetaxel-oxaliplatin-adriamycin in 12 (25.5%), and paclitaxel alone in 2 (4.2%) patients. Grade 1-2 complications were observed in 24 (51%) and grade 3-4 complications in 6 (12.7%) patients (8.5% of 82 PIPACs). 16/47 (34.0%) patients had a clinical response to PIPAC. The mean PCI was 25.9 ± 9.2 for the first PIPACs and 22.4 ± 9 for the subsequent PIPACs with an average reduction of 3.6 points [change in PCI ranged from - 14 to + 8]. The PRGS was 1/2 in 4/47 (8.5%) patients (19.0% patients with > 1 PIPAC). A reduction in ascites was observed in 35.4% presenting with ascites. Nine (19.1%) patients had conversion to operability leading to a subsequent cytoreductive surgery in 8 (17%) patients. PIPAC with docetaxel is feasible and safe. The role of PIPAC with both docetaxel and paclitaxel either alone or in combination with other drugs should be investigated in prospective studies.
摘要：
紫杉烷类对腹膜内应用具有有利的药代动力学特征。在安全性方面，我们报告了紫杉烷-PIPAC（加压腹膜内化疗）用于不同原发部位不可切除的腹膜转移的初步经验。可行性,响应率,并转换为可切除性。在这项回顾性研究中,PIPAC单独或与全身化疗联合进行。紫杉醇作为单一药物使用，而多西他赛与顺铂-阿霉素或奥沙利铂-阿霉素联合使用。从2019年12月到2021年12月，47例患者接受了82例PIPAC手术（1例PIPAC占55.3%，2在29.7%中，3中14.8%）。最常见的原发部位是卵巢癌（31.9%），胃癌（23.4%），结直肠癌（21.2%）。33例（70.2%）患者使用多西他赛-顺铂-阿霉素，多西他赛-奥沙利铂-阿霉素12例（25.5%），2例（4.2％）患者仅使用紫杉醇。在24例（51％）患者中观察到1-2级并发症，在6例（12.7％）患者中观察到3-4级并发症（82个PIPAC中的8.5％）。16/47（34.0％）患者对PIPAC有临床反应。第一个PIPAC的平均PCI为25.9±9.2，随后的PIPAC的平均PCI为22.4±9，平均减少3.6分[PCI的变化范围为-14至+8]。在4/47（8.5％）患者（>1PIPAC的19.0％患者）中，PRGS为1/2。在出现腹水的35.4%中观察到腹水减少。9名（19.1％）患者转换为可操作性，导致8名（17％）患者随后进行细胞减灭术。PIPAC联合多西他赛是可行和安全的。PIPAC与多西他赛和紫杉醇单独或与其他药物联合使用的作用应在前瞻性研究中进行研究。
