Olivia Sgarbura1, Martin Hübner2, Mohammad Alyami3, Clarisse Eveno4, Johan Gagnière5, Basile Pache2, Marc Pocard6, Naoual Bakrin7, François Quénet8. 1. Department of Surgical Oncology, Cancer Institute Montpellier (ICM), Montpellier, France; University of Montpellier, France. Electronic address: olivia.sgarbura@icm.unicancer.fr. 2. Department of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland. 3. Department of General Surgery and Surgical Oncology, Lyon Sud University Hospital, Pierre Benite, France; Department of General Surgery and Surgical Oncology, King Khalid Hospital, Najran, Saudi Arabia. 4. Department of General Surgery, University Hospital Lille, Lille, France. 5. Centre Hospitalier Universitaire Clermont-Ferrand, France. 6. INSERM U1275, CAP Paris-Tech, Carcinomatosis Peritoneum Paris Technology, Lariboisière Hospital, AP-HP, Paris 7- Diderot University, Sorbonne Paris Cité, France. 7. Department of General Surgery and Surgical Oncology, Lyon Sud University Hospital, Pierre Benite, France. 8. Department of Surgical Oncology, Cancer Institute Montpellier (ICM), Montpellier, France; University of Montpellier, France.
Abstract
INTRODUCTION: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new drug delivery method used in patients with peritoneal cancer (PC) of primary or secondary origin. Intraperitoneal use of oxaliplatin raises concerns about toxicity, especially abdominal pain. The objective of this study was to assess the tolerance of PIPAC with oxaliplatin (PIPAC-Ox) in a large cohort of patients and to identify the risk factors for high grade toxicity, discontinuation of treatment and impaired survival. MATERIAL AND METHODS: This retrospective cohort study included all consecutive patients treated with PIPAC-Ox (92 mg/m2) in five centers specialized in the treatment of PC. The procedure was repeated every 6 weeks. Outcomes of interest were Common Terminology Criteria for Adverse Events (CTCAE), symptoms and survival (Kaplan-Meier). Univariate risk factors were included in a multinominal regression model to control for bias. RESULTS: Overall, 251 PIPAC-Ox treatments were performed in 101 patients (45 female) having unresectable PC of various origins: 66 colorectal, 15 gastric, 5 ovarian, 3 mesothelioma, 2 pseudomyxoma, 10 other malignancies (biliary, pancreatic, endocrine) respectively. The median PCI was 19 (IQR: 10-28). Postoperative abdominal pain was present in 23 patients. Out of the 9 patients with grade 3 abdominal pain, only 3 needed a change of PIPAC drug. CTCAE 4.0 toxicity grade 4 or higher was encountered in 16(15.9%) patients. The patients had a mean of 2.5 procedures/patient (SD = 1.5). 50 subjects presented with symptom improvement. CONCLUSIONS: Oxaliplatin-based PIPAC appears to be a safe treatment that offers good symptom control and promising survival for patients with advanced peritoneal disease.
INTRODUCTION:Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new drug delivery method used in patients with peritoneal cancer (PC) of primary or secondary origin. Intraperitoneal use of oxaliplatin raises concerns about toxicity, especially abdominal pain. The objective of this study was to assess the tolerance of PIPAC with oxaliplatin (PIPAC-Ox) in a large cohort of patients and to identify the risk factors for high grade toxicity, discontinuation of treatment and impaired survival. MATERIAL AND METHODS: This retrospective cohort study included all consecutive patients treated with PIPAC-Ox (92 mg/m2) in five centers specialized in the treatment of PC. The procedure was repeated every 6 weeks. Outcomes of interest were Common Terminology Criteria for Adverse Events (CTCAE), symptoms and survival (Kaplan-Meier). Univariate risk factors were included in a multinominal regression model to control for bias. RESULTS: Overall, 251 PIPAC-Ox treatments were performed in 101 patients (45 female) having unresectable PC of various origins: 66 colorectal, 15 gastric, 5 ovarian, 3 mesothelioma, 2 pseudomyxoma, 10 other malignancies (biliary, pancreatic, endocrine) respectively. The median PCI was 19 (IQR: 10-28). Postoperative abdominal pain was present in 23 patients. Out of the 9 patients with grade 3 abdominal pain, only 3 needed a change of PIPAC drug. CTCAE 4.0 toxicity grade 4 or higher was encountered in 16(15.9%) patients. The patients had a mean of 2.5 procedures/patient (SD = 1.5). 50 subjects presented with symptom improvement. CONCLUSIONS:Oxaliplatin-based PIPAC appears to be a safe treatment that offers good symptom control and promising survival for patients with advanced peritoneal disease.
Authors: Robin J Lurvink; Koen P Rovers; Simon W Nienhuijs; Geert-Jan Creemers; Jacobus W A Burger; Ignace H J de Hingh Journal: J Gastrointest Oncol Date: 2021-04
Authors: Robin J Lurvink; Koen P Rovers; Emma C E Wassenaar; Checca Bakkers; Jacobus W A Burger; Geert-Jan M Creemers; Maartje Los; Floortje Mols; Marinus J Wiezer; Simon W Nienhuijs; Djamila Boerma; Ignace H J T de Hingh Journal: Surg Endosc Date: 2021-11-10 Impact factor: 3.453
Authors: Daniel Clerc; Martin Hübner; K R Ashwin; S P Somashekhar; Beate Rau; Wim Ceelen; Wouter Willaert; Naoual Bakrin; Nathalie Laplace; Mohammed Al Hosni; Edgar Luis Garcia Lozcano; Sebastian Blaj; Pompiliu Piso; Andrea Di Giorgio; Giuseppe Vizzelli; Cécile Brigand; Jean-Baptiste Delhorme; Amandine Klipfel; Rami Archid; Giorgi Nadiradze; Marc A Reymond; Olivia Sgarbura Journal: Pleura Peritoneum Date: 2021-02-12