Comparing patient reported abdominal pain between patients treated with oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (PIPAC-OX) and primary colorectal cancer surgery

Vincent C J van de Vlasakker, Robin J Lurvink, Emma C Wassenaar, Paulien Rauwerdink, Checca Bakkers, Koen P Rovers, Cynthia S Bonhof, Jacobus W A Burger, Marinus J Wiezer, Djamila Boerma, Simon W Nienhuijs, Floortje Mols, Ignace H J T de Hingh*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (PIPAC-OX) is an emerging palliative treatment for patients with unresectable colorectal peritoneal metastases. Previously, our study group reported that patients experienced abdominal pain for several weeks after PIPAC-OX. However, it is unknown how this compares to abdominal pain after regular colorectal cancer surgery. To provide some perspective, this study compared the presence of abdominal pain after PIPAC-OX to the presence of abdominal pain after primary tumor surgery. Patient reported abdominal pain scores (EORTC QLQ-CR-29), from two prospective, Dutch cohorts were used in this study. Scores ranged from 0 to 100, a higher score represents more abdominal pain. Abdominal pain at baseline and at four weeks after treatment were compared between the two groups. Twenty patients who underwent PIPAC-OX and 322 patients who underwent primary tumor surgery were included in the analysis. At baseline, there were no differences in abdominal pain between both groups (mean 20 vs. 18, respectively; p?=?0.688). Four weeks after treatment, abdominal pain was significantly worse in the PIPAC group (39 vs 15, respectively; p?<?0.001; Cohen's d?=?0.99). The differential effect over time for abdominal pain differed significantly between both groups (mean difference: 19 vs -?3, respectively; p?=?0.004; Cohen's d?=?0.88). PIPAC-OX resulted in significantly worse postoperative abdominal pain than primary tumor surgery. These results can be used for patient counseling and stress the need for adequate analgesia during and after PIPAC-OX. Further research is required to prevent or reduce abdominal pain after PIPAC-OX.Trial registration CRC-PIPAC: Clinicaltrails.gov NCT03246321 (01-10-2017).
Original languageEnglish
Article number20458
Number of pages6
JournalScientific Reports
Volume13
Issue number1
DOIs
Publication statusPublished - 22 Nov 2023

Keywords

  • Humans
  • Oxaliplatin/therapeutic use
  • Antineoplastic Agents/adverse effects
  • Prospective Studies
  • Peritoneal Neoplasms/secondary
  • Aerosols
  • Colorectal Neoplasms/drug therapy surgery chemically induced
  • Abdominal Pain/etiology drug therapy
  • Patient Reported Outcome Measures

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