Unresectable colorectal peritoneal metastases: Exploring the role of PIPAC

This thesis provided an overview of the incidence, treatment, and prognosis of colorectal peritoneal metastases and focused on the potential role of treatment with PIPAC in the palliative setting. PIPAC is a new method of administering chemotherapy into the abdomen as a pressurized aerosol, with potential advantages over systemic chemotherapy. Despite the worldwide growing popularity of PIPAC, there is no scientific evidence that confirms the superiority or non-inferiority of PIPAC over systemic chemotherapy. Hence, two studies were initiated in the Netherlands to gain more insight into the side effects and tolerability, anti-tumour efficacy, and costs of treatment with PIPAC, and quality of life during treatment with PIPAC. The first study (CRC-PIPAC) focused on repetitive treatment with PIPAC every 4-6 weeks without systemic chemotherapy in between, the results of which are reported in this thesis. The second study (CRC-PIPAC-II) focused on repetitive PIPAC alternated with systemic chemotherapy, the results of which are expected over the course of 2022.