A brand new means of delivering chemotherapy medicine to the location of a peritoneal mesothelioma tumor has some distinctive advantages, however can be dangerous.
The method, referred to as pressurized intraperitoneal aerosol chemotherapy (PIPAC) permits docs to “spray” an answer of chemotherapy medicine instantly onto peritoneal tumors by way of small ports within the stomach.
The intention is to uniformly coat the tumor and assist maintain chemotherapy medicine in touch with malignant mesothelioma or different peritoneal cancer cells for so long as potential.
Testing PIPAC for Unresectable Mesothelioma
The PIPAC method is being pioneered in Europe. In a brand new French research, docs examined it in 73 sufferers who had peritoneal mesothelioma or metastatic colorectal, gastric, or ovarian cancer on the peritoneal membrane lining the stomach. To be included within the research, sufferers needed to have tumors that would not be eliminated surgically.
All collectively, the research topics underwent a complete of 164 PIPAC procedures. All of the sufferers had multiple PIPAC treatment and one affected person had a complete of six.
Good and Bad News for Mesothelioma Patients
The peritoneal cancer index (PCI), a measure of the extent of a affected person’s peritoneal cancer, improved in 64.5% of sufferers. For 63.5% of sufferers, their peritoneal cancer signs, together with ache, bloating, diarrhea and constipation, utterly cleared up after PIPAC.
But there was a draw back to PIPAC treatment for patients with malignant mesothelioma and different peritoneal cancers; virtually 10% of sufferers skilled main problems and 5 sufferers died inside 30 days.
Physician Experience Lowers Risk
In the primary 20 sufferers handled, the mortality fee from PIPAC was 40% and the speed of problems was 62%. Both charges regularly improved as docs turned more proficient on the process. Eighty-eight % of sufferers have been capable of bear systemic chemotherapy inside a couple of weeks after PIPAC to enhance their cancer management.
The researchers conclude that, whereas it’s “feasible” to ship PIPAC together with systemic chemotherapy, it additionally poses vital dangers for mesothelioma patients and others with peritoneal cancer.
“Implementing a PIPAC program in association with systemic chemotherapy is…associated with a risk of postoperative morbidity, even in teams highly experienced in PC management and requires a learning curve in patient selection,” concludes lead writer Mohammad Aliyami, MD, with Centre Hospitalier Lyon-Sud.
The report seems in a current problem of the European Journal of Surgical Oncology.
Aliyami, M, “Multicentric initial experience with the use of the pressurized intraperitoneal aerosol chemotherapy (PIPAC) in the management of unresectable peritoneal carcinomatosis”, September 21, 2017, European Journal of Surgical Oncology, Epub forward of print