Pressurized intraperitoneal aerosol chemotherapy with oxaliplatin (PIPAC-OX) in patients with colorectal peritoneal metastases - a systematic review

R.J. Lurvink, K.P. Rovers, S.W. Nienhuijs, G.J. Creemers, J.W.A. Burger, I.H.J. de Hingh*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

5 Citations (Web of Science)

Abstract

Pressurized intraperitoneal aerosol chemotherapy with oxaliplatin (PIPAC-OX) is increasingly used as a palliative treatment option for patients with colorectal peritoneal metastases (CPM). The present study aimed to systematically review all clinical studies reporting safety and efficacy outcomes of PIPAC-OX in patients with CPM.. PubMed, EMBASE, The Cochrane Library, and CINAHL were systematically searched to identify all clinical studies that included at least one patient with CPM treated with PIPAC-OX and reported one of the following outcomes: adverse events, tumor response, quality of life, secondary cytoreductive surgery, progression-free survival, overall survival, and environmental safety of PIPAC-OX. Results were narratively described. Of 28 included studies, only 14 non-comparative studies separately reported at least one outcome of PIPAC-OX for CPM, of which only two studies specifically focused on this group. These 14 studies reported adverse events (5 studies), tumor response (5 studies), secondary cytoreductive surgery (4 studies), progression-free survival (1 study), overall survival (5 studies), and environmental safety (2 studies). Except for 5 studies (describing 26 patients), none of the included studies stratified their results for PIPAC-OX monotherapy and PIPAC-OX with concomitant systemic therapy, and none of the studies reporting survival outcomes stratified results for line of palliative treatment, complicating interpretation. No PIPAC-OX related deaths were reported. No occupational platinum was detected during PIPAC-OX. The available evidence regarding PIPAC-OX for CPM. is limited and difficult to interpret. Despite these limitations, PIPAC-OX appears safe in patients with CPM and safe for operating personnel. To increase insight in the role of PIPAC-OX in this setting, investigators of ongoing and future studies are encouraged to report separate outcomes of PIPAC-OX for CPM, to stratify their results for PIPAC-OX monotherapy and PIPAC-OX with concomitant systemic therapy, and to stratify survival results for line of palliative treatment.
Original languageEnglish
Pages (from-to)S242-+
Number of pages20
JournalJournal of Gastrointestinal Oncology
Volume12
DOIs
Publication statusPublished - 1 Apr 2021

Keywords

  • Pressurized intraperitoneal aerosol chemotherapy (PIPAC)
  • colorectal cancer
  • peritoneal metastases
  • oxaliplatin
  • LOW-DOSE CISPLATIN
  • QUALITY-OF-LIFE
  • GASTRIC-CANCER
  • OVARIAN-CANCER
  • OCCUPATIONAL-HEALTH
  • INITIAL-EXPERIENCE
  • CARCINOMATOSIS
  • DOXORUBICIN
  • THERAPY
  • SAFETY

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