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Archives of Gynecology and Obstetrics

Published in:

01-08-2018 | Review

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for peritoneal carcinomatosis: systematic review of clinical and experimental evidence with special emphasis on ovarian cancer

Authors: Clemens Tempfer, Urs Giger-Pabst, Ziad Hilal, Askin Dogan, Günther A. Rezniczek

Published in: Archives of Gynecology and Obstetrics | Issue 2/2018

Abstract

Background

Systemic chemotherapy is not effective in patients with peritoneal carcinomatosis (PC) and only a minority of affected patients is eligible for cytoreductive surgery. Intraperitoneal chemotherapy may provide a therapy alternative for these patients.

Methods

We performed a systematic review of clinical and experimental evidence on the safety and efficacy of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with PC and provide clinical recommendations based on the available evidence.

Results

Fifty-eight reports were identified, categorized as experimental (18 reports), clinical (28 reports), and other articles (14 reports). Experimental studies demonstrated improved tissue penetration and peritoneal coverage. The 28 clinical studies reported on 3515 procedures in 1547 patients with PC of various primary tumors with 16 of these studies reporting on patients with ovarian cancer. Toxicity was manageable. Based on 1197 patients in 22 studies, adverse events CTCAE grades 1, 2, 3, 4, and 5 were observed in 537 (45%), 167 (14%), 83 (7%), 10 (0.8%), and 19 (1.6%) cases, respectively. In a pooled analysis, the objective tumor response rate was 69% and the mean overall survival duration was 13.7 months. No significant hepatic, renal, or hematologic toxicity was described. PIPAC maintained and/or improved quality of life, as reported in 10 studies with 396 patients.

Conclusions

Available evidence from controlled trials (phase I and phase II) and retrospective cohort studies in > 1500 patients unequivocally demonstrates that PIPAC is feasible, safe, and effective. PIPAC maintains quality of life in patients with recurrent cancer and PC. PIPAC is as evidence-based as any other treatment in women with ovarian cancer and PC beyond the third line of systemic chemotherapy and can be recommended in this indication.

Malvezzi M, Carioli G, Rodriguez T et al (2016) Global trends and predictions in ovarian cancer mortality. Ann Oncol 27(11):2017–2025. https://doi.org/10.1093/annonc/mdw306 CrossRefPubMed

Wu YS, Shui L, Shen D et al (2017) Bevacizumab combined with chemotherapy for ovarian cancer: an updated systematic review and meta-analysis of randomized controlled trials. Oncotarget 8(6):10703–10713. https://doi.org/10.18632/oncotarget.12926 PubMedCrossRef

Oza AM, Cook AD, Pfisterer J et al (2015) Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomised trial. Lancet Oncol 16(8):928–936. https://doi.org/10.1016/S1470-2045(15)00086-8 CrossRefPubMedPubMedCentral

Foley OW, Rauh-Hain JA, del Carmen MG (2013) Recurrent epithelial ovarian cancer: An update on treatment. Oncology (Williston Park, N Y) 27(4):288–294

Harter P, Sehouli J, Reuss A et al (2011) Prospective validation study of a predictive score for operability of recurrent ovarian cancer: the Multicenter Intergroup Study DESKTOP II. A project of the AGO Kommission OVAR, AGO Study Group, NOGGO, AGO-Austria, and MITO. Int J Gynecol Cancer 21(2):289–295. https://doi.org/10.1097/IGC.0b013e31820aaafd CrossRefPubMed

Pujade-Lauraine E, Ledermann JA, Selle F et al (2017) Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol 18(9):1274–1284. https://doi.org/10.1016/S1470-2045(17)30469-2 CrossRefPubMed

Mirza MR, Monk BJ, Herrstedt J et al (2016) Niraparib maintenance therapy in platinum-sensitive, recurrent ovarian cancer. N Engl J Med 375(22):2154–2164. https://doi.org/10.1056/NEJMoa1611310 CrossRefPubMed

Du Bois A, Vergote I, Ferron G et al (2017) Randomized controlled phase III study evaluating the impact of secondary cytoreductive surgery in recurrent ovarian cancer: AGO DESKTOP III/ENGOT ov20. J Clin Oncol 35(15_suppl):5501. https://doi.org/10.1200/jco.2017.35.15_suppl.5501 CrossRef

Hanker LC, Loibl S, Burchardi N et al (2012) The impact of second to sixth line therapy on survival of relapsed ovarian cancer after primary taxane/platinum-based therapy. Ann Oncol 23(10):2605–2612. https://doi.org/10.1093/annonc/mds203 CrossRefPubMed

10.

Dedrick RL, Flessner MF (1997) Pharmacokinetic problems in peritoneal drug administration: tissue penetration and surface exposure. J Natl Cancer Inst 89(7):480–487CrossRefPubMed

11.

Markman M (2003) Intraperitoneal antineoplastic drug delivery: rationale and results. Lancet Oncol 4(5):277–283CrossRefPubMed

12.

Kayl AE, Meyers CA (2006) Side-effects of chemotherapy and quality of life in ovarian and breast cancer patients. Curr Opin Obstet Gynecol 18(1):24–28. https://doi.org/10.1097/01.gco.0000192996.20040.24 CrossRefPubMed

13.

Sun CC, Frumovitz M, Bodurka DC (2005) Quality of life and gynecologic malignancies. Curr Oncol Rep 7(6):459–465CrossRefPubMed

14.

Lindemann K, Gibbs E, Åvall-Lundqvist E et al (2017) Chemotherapy vs tamoxifen in platinum-resistant ovarian cancer: a phase III, randomised, multicentre trial (Ovaresist). Br J Cancer 116(4):455–463. https://doi.org/10.1038/bjc.2016.435 CrossRefPubMedPubMedCentral

15.

Armstrong DK, Bundy B, Wenzel L et al (2006) Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 354(1):34–43. https://doi.org/10.1056/NEJMoa052985 CrossRefPubMed

16.

Gadducci A, Conte PF (2008) Intraperitoneal chemotherapy in the management of patients with advanced epithelial ovarian cancer: a critical review of the literature. Int J Gynecol Cancer 18(5):943–953. https://doi.org/10.1111/j.1525-1438.2007.01163.x CrossRefPubMed

17.

Eskander RN, Tewari KS (2012) Emerging treatment options for management of malignant ascites in patients with ovarian cancer. Int J Womens Health 4:395–404. https://doi.org/10.2147/IJWH.S29467 PubMedPubMedCentralCrossRef

18.

Woopen H, Sehouli J (2009) Current and future options in the treatment of malignant ascites in ovarian cancer. Anticancer Res 29(8):3353–3359PubMed

19.

Reymond MA, Hu B, Garcia A et al (2000) Feasibility of therapeutic pneumoperitoneum in a large animal model using a microvaporisator. Surg Endosc 14(1):51–55CrossRefPubMed

20.

Solass W, Hetzel A, Nadiradze G et al (2012) Description of a novel approach for intraperitoneal drug delivery and the related device. Surg Endosc 26(7):1849–1855. https://doi.org/10.1007/s00464-012-2148-0 CrossRefPubMed

21.

Solass W, Herbette A, Schwarz T et al (2012) Therapeutic approach of human peritoneal carcinomatosis with Dbait in combination with capnoperitoneum: proof of concept. Surg Endosc 26(3):847–852CrossRefPubMed

22.

Tempfer CB, Winnekendonk G, Solass W et al (2015) Pressurized intraperitoneal aerosol chemotherapy in women with recurrent ovarian cancer: a phase 2 study. Gynecol Oncol 137(2):223–228. https://doi.org/10.1016/j.ygyno.2015.02.009 CrossRefPubMed

23.

Tempfer CB, Solass W, Buerkle B et al (2014) Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in a woman with pseudomyxoma peritonei: a case report. Gynecol Oncol Rep 10:32–35. https://doi.org/10.1016/j.gore.2014.10.001 CrossRefPubMedPubMedCentral

24.

Nadiradze G, Giger-Pabst U, Zieren J et al (2016) Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with low-dose cisplatin and doxorubicin in gastric peritoneal metastasis. J Gastrointest Surg 20(2):367–373. https://doi.org/10.1007/s11605-015-2995-9 CrossRefPubMed

25.

Demtröder C, Solass W, Zieren J et al (2016) Pressurized intraperitoneal aerosol chemotherapy with oxaliplatin in colorectal peritoneal metastasis. Colorectal Dis 18(4):364–371. https://doi.org/10.1111/codi.13130 CrossRefPubMed

26.

National Cancer Institute (2010) Common terminology criteria for adverse events (CTCAE) v4.03. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm. Accessed 30 Jan 2018

27.

Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45(2):228–247. https://doi.org/10.1016/j.ejca.2008.10.026 CrossRefPubMed

28.

Khosrawipour V, Diaz-Carballo D, Acikelli A-H et al (2017) Cytotoxic effect of different treatment parameters in pressurized intraperitoneal aerosol chemotherapy (PIPAC) on the in vitro proliferation of human colonic cancer cells. World J Surg Oncol 15(1):43. https://doi.org/10.1186/s12957-017-1109-4 CrossRefPubMedPubMedCentral

29.

Khosrawipour V, Khosrawipour T, Hedayat-Pour Y et al (2017) Effect of whole-abdominal irradiation on penetration depth of doxorubicin in normal tissue after pressurized intraperitoneal aerosol chemotherapy (PIPAC) in a post-mortem swine model. Anticancer Res 37(4):1677–1680. https://doi.org/10.21873/anticanres.11498 CrossRefPubMed

30.

Göhler D, Khosrawipour V, Khosrawipour T et al (2017) Technical description of the microinjection pump (MIP^®) and granulometric characterization of the aerosol applied for pressurized intraperitoneal aerosol chemotherapy (PIPAC). Surg Endosc 31(4):1778–1784. https://doi.org/10.1007/s00464-016-5174-5 CrossRefPubMed

31.

Khosrawipour V, Khosrawipour T, Falkenstein TA et al (2016) Evaluating the effect of Micropump© position, internal pressure and doxorubicin dosage on efficacy of pressurized intra-peritoneal aerosol chemotherapy (PIPAC) in an ex vivo model. Anticancer Res 36(9):4595–4600. https://doi.org/10.21873/anticanres.11008 CrossRefPubMed

32.

Khosrawipour V, Bellendorf A, Khosrawipour C et al (2016) Irradiation does not increase the penetration depth of doxorubicin in normal tissue after pressurized intra-peritoneal aerosol chemotherapy (PIPAC) in an ex vivo model. Vivo 30(5):593–597

33.

Rezniczek GA, Jüngst F, Jütte H et al (2016) Dynamic changes of tumor gene expression during repeated pressurized intraperitoneal aerosol chemotherapy (PIPAC) in women with peritoneal cancer. BMC Cancer 16:654. https://doi.org/10.1186/s12885-016-2668-4 CrossRefPubMedPubMedCentral

34.

Khosrawipour V, Khosrawipour T, Diaz-Carballo D et al (2016) Exploring the spatial drug distribution pattern of pressurized intraperitoneal aerosol chemotherapy (PIPAC). Ann Surg Oncol 23(4):1220–1224. https://doi.org/10.1245/s10434-015-4954-9 CrossRefPubMed

35.

Göhler D, Große S, Bellendorf A et al (2017) Hyperthermic intracavitary nanoaerosol therapy (HINAT) as an improved approach for pressurised intraperitoneal aerosol chemotherapy (PIPAC): technical description, experimental validation and first proof of concept. Beilstein J Nanotechnol 8:2729–2740. https://doi.org/10.3762/bjnano.8.272 CrossRefPubMedPubMedCentral

36.

Seitenfus R, Ferreira PRW, Santos GOD et al (2017) A prototype single-port device for pressurized intraperitoneal aerosol chemotherapy. Technical feasibility and local drug distribution. Acta Cir Bras 32(12):1056–1063. https://doi.org/10.1590/s0102-865020170120000007 CrossRefPubMed

37.

Bellendorf A, Khosrawipour V, Khosrawipour T et al (2018) Scintigraphic peritoneography reveals a non-uniform ^99mTc-pertechnetat aerosol distribution pattern for pressurized intra-peritoneal aerosol chemotherapy (PIPAC) in a swine model. Surg Endosc 32(1):166–174. https://doi.org/10.1007/s00464-017-5652-4 CrossRefPubMed

38.

Khosrawipour V, Khosrawipour T, Kern AJP et al (2016) Distribution pattern and penetration depth of doxorubicin after pressurized intraperitoneal aerosol chemotherapy (PIPAC) in a postmortem swine model. J Cancer Res Clin Oncol 142(11):2275–2280. https://doi.org/10.1007/s00432-016-2234-0 CrossRefPubMed

39.

Kakchekeeva T, Demtröder C, Herath NI et al (2016) In vivo feasibility of electrostatic precipitation as an adjunct to pressurized intraperitoneal aerosol chemotherapy (ePIPAC). Ann Surg Oncol 23(Suppl 5):592–598. https://doi.org/10.1245/s10434-016-5108-4 CrossRefPubMedPubMedCentral

40.

Jung DH, Son SY, Oo AM et al (2016) Feasibility of hyperthermic pressurized intraperitoneal aerosol chemotherapy in a porcine model. Surg Endosc 30(10):4258–4264. https://doi.org/10.1007/s00464-015-4738-0 CrossRef

41.

Solass W, Kerb R, Mürdter T et al (2014) Intraperitoneal chemotherapy of peritoneal carcinomatosis using pressurized aerosol as an alternative to liquid solution: first evidence for efficacy. Ann Surg Oncol 21(2):553–559. https://doi.org/10.1245/s10434-013-3213-1 CrossRefPubMed

42.

Nowacki M, Alyami M, Villeneuve L et al (2018) Multicenter comprehensive methodological and technical analysis of 832 pressurized intraperitoneal aerosol chemotherapy (PIPAC) interventions performed in 349 patients for peritoneal carcinomatosis treatment: an international survey study. Eur J Surg Oncol. https://doi.org/10.1016/j.ejso.2018.02.014 PubMedCrossRef

43.

Teixeira Farinha H, Grass F, Labgaa I et al (2018) Inflammatory response and toxicity after pressurized intraperitoneal aerosol chemotherapy. J Cancer 9(1):13–20. https://doi.org/10.7150/jca.21460 CrossRefPubMedPubMedCentral

44.

Falkenstein TA, Götze TO, Ouaissi M et al (2018) First clinical data of pressurized intraperitoneal aerosol chemotherapy (PIPAC) as salvage therapy for peritoneal metastatic biliary tract cancer. Anticancer Res 38(1):373–378. https://doi.org/10.21873/anticanres.12232 PubMedCrossRef

45.

Hilal Z, Rezniczek GA, Klenke R et al (2017) Nutritional status, cachexia, and anorexia in women with peritoneal metastasis and intraperitoneal chemotherapy: a longitudinal analysis. J Gynecol Oncol 28(6):e80. https://doi.org/10.3802/jgo.2017.28.e80 CrossRefPubMedPubMedCentral

46.

Alyami M, Gagniere J, Sgarbura O et al (2017) Multicentric initial experience with the use of the pressurized intraperitoneal aerosol chemotherapy (PIPAC) in the management of unresectable peritoneal carcinomatosis. Eur J Surg Oncol 43(11):2178–2183. https://doi.org/10.1016/j.ejso.2017.09.010 CrossRefPubMed

47.

Cazauran J-B, Alyami M, Lasseur A et al (2018) Pressurized intraperitoneal aerosol chemotherapy (PIPAC) procedure for non-resectable peritoneal carcinomatosis (with video). J Gastrointest Surg 22(2):374–375. https://doi.org/10.1007/s11605-017-3565-0 CrossRefPubMed

48.

Graversen M, Detlefsen S, Bjerregaard JK et al (2017) Peritoneal metastasis from pancreatic cancer treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). Clin Exp Metastasis 34(5):309–314. https://doi.org/10.1007/s10585-017-9849-7 CrossRefPubMed

49.

Hübner M, Teixeira Farinha H, Grass F et al (2017) Feasibility and safety of pressurized intraperitoneal aerosol chemotherapy for peritoneal carcinomatosis: a retrospective cohort study. Gastroenterol Res Pract 2017:6852749. https://doi.org/10.1155/2017/6852749 CrossRefPubMedPubMedCentral

50.

Teixeira Farinha H, Grass F, Kefleyesus A et al (2017) Impact of pressurized intraperitoneal aerosol chemotherapy on quality of life and symptoms in patients with peritoneal carcinomatosis: a retrospective cohort study. Gastroenterol Res Pract 2017:4596176. https://doi.org/10.1155/2017/4596176 CrossRefPubMedPubMedCentral

51.

Tempfer CB, Hartmann F, Hilal Z et al (2017) Intraperitoneal cisplatin and doxorubicin as maintenance chemotherapy for unresectable ovarian cancer: a case report. BMC Cancer 17(1):26. https://doi.org/10.1186/s12885-016-3004-8 CrossRefPubMedPubMedCentral

52.

Girshally R, Demtröder C, Albayrak N et al (2016) Pressurized intraperitoneal aerosol chemotherapy (PIPAC) as a neoadjuvant therapy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Surg Oncol 14(1):253. https://doi.org/10.1186/s12957-016-1008-0 CrossRefPubMedPubMedCentral

53.

Blanco A, Giger-Pabst U, Solass W et al (2013) Renal and hepatic toxicities after pressurized intraperitoneal aerosol chemotherapy (PIPAC). Ann Surg Oncol 20(7):2311–2316. https://doi.org/10.1245/s10434-012-2840-2 CrossRefPubMedPubMedCentral

54.

Robella M, Vaira M, de Simone M (2016) Safety and feasibility of pressurized intraperitoneal aerosol chemotherapy (PIPAC) associated with systemic chemotherapy: an innovative approach to treat peritoneal carcinomatosis. World J Surg Oncol 14:128. https://doi.org/10.1186/s12957-016-0892-7 CrossRefPubMedPubMedCentral

55.

Tempfer CB, Rezniczek GA, Ende P et al (2015) Pressurized intraperitoneal aerosol chemotherapy with cisplatin and doxorubicin in women with peritoneal carcinomatosis: a cohort study. Anticancer Res 35(12):6723–6729PubMed

56.

Odendahl K, Solass W, Demtröder C et al (2015) Quality of life of patients with end-stage peritoneal metastasis treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). Eur J Surg Oncol 41(10):1379–1385. https://doi.org/10.1016/j.ejso.2015.06.001 CrossRefPubMed

57.

Giger-Pabst U, Solass W, Buerkle B et al (2015) Low-dose pressurized intraperitoneal aerosol chemotherapy (PIPAC) as an alternative therapy for ovarian cancer in an octogenarian patient. Anticancer Res 35(4):2309–2314PubMed

58.

Tempfer CB, Celik I, Solass W et al (2014) Activity of pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in women with recurrent, platinum-resistant ovarian cancer: preliminary clinical experience. Gynecol Oncol 132(2):307–311. https://doi.org/10.1016/j.ygyno.2013.11.022 CrossRefPubMed

59.

Hübner M, Grass F, Teixeira-Farinha H et al (2017) Pressurized intraperitoneal aerosol chemotherapy—practical aspects. Eur J Surg Oncol 43(6):1102–1109. https://doi.org/10.1016/j.ejso.2017.03.019 CrossRefPubMed

60.

Nowacki M, Peterson M, Kloskowski T et al (2017) Nanoparticle as a novel tool in hyperthermic intraperitoneal and pressurized intraperitoneal aerosol chemotherapy to treat patients with peritoneal carcinomatosis. Oncotarget 8(44):78208–78224. https://doi.org/10.18632/oncotarget.20596 CrossRefPubMedPubMedCentral

61.

Grass F, Vuagniaux A, Teixeira-Farinha H et al (2017) Systematic review of pressurized intraperitoneal aerosol chemotherapy for the treatment of advanced peritoneal carcinomatosis. Br J Surg 104(6):669–678. https://doi.org/10.1002/bjs.10521 CrossRefPubMed

62.

Glockzin G, Schlitt HJ, Piso P (2016) Therapeutic options for peritoneal metastasis arising from colorectal cancer. World J Gastrointest Pharmacol Ther 7(3):343–352. https://doi.org/10.4292/wjgpt.v7.i3.343 CrossRefPubMedPubMedCentral

63.

Graversen M, Pfeiffer P, Mortensen MB (2016) Treatment of peritoneal carcinomatosis with pressurized intraperitoneal aerosol chemotherapy. Ugeskr Laeger 178(21):2

64.

Tempfer CB (2015) Pressurized intraperitoneal aerosol chemotherapy as an innovative approach to treat peritoneal carcinomatosis. Med Hypotheses 85(4):480–484. https://doi.org/10.1016/j.mehy.2015.07.001 CrossRefPubMed

65.

Hübner M, Teixeira H, Boussaha T et al (2015) PIPAC-Chimiothérapie intrapéritonéale vaporisée. Un traitement innovateur de la carcinose péritonéale (PIPAC–Pressurized intraperitoneal aerosol chemotherapy. A novel treatment for peritoneal carcinomatosis). Rev Med Suisse 11(479):1325–1330PubMed

66.

Sabaila A, Fauconnier A, Huchon C (2015) Chimiothérapie intrapéritonéale pressurisée en aérosol (CIPPA): Une nouvelle voie d’administration dans les carcinoses péritonéales d’origine ovarienne (Pressurized intraperitoneal aerosol chemotherapy (PIPAC): a new way of administration in peritoneal carcinomatosis of ovarian cancer). Gynecol Obstet Fertil 43(1):66–67. https://doi.org/10.1016/j.gyobfe.2014.11.012 CrossRefPubMed

67.

Tempfer CB, Solass W, Reymond M-A (2014) Pressurized intraperitoneal chemotherapy (PIPAC) in women with gynecologic malignancies: a review. Wien Med Wochenschr 164(23–24):519–528. https://doi.org/10.1007/s10354-014-0312-y CrossRefPubMed

68.

Schmid BC, Oehler MK (2014) New perspectives in ovarian cancer treatment. Maturitas 77(2):128–136. https://doi.org/10.1016/j.maturitas.2013.11.009 CrossRefPubMed

69.

Dueckelmann AM, Fink D, Harter P et al (2018) The use of PIPAC (pressurized intraperitoneal aerosol chemotherapy) in gynecological oncology: a statement by the German “Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR)”, the Swiss and Austrian AGO, and the North-Eastern German Society of Gynaecologic Oncology. Arch Gynecol Obstet 297(4):837–846. https://doi.org/10.1007/s00404-018-4673-0 CrossRefPubMed

70.

Solass W, Giger-Pabst U, Zieren J et al (2013) Pressurized intraperitoneal aerosol chemotherapy (PIPAC): occupational health and safety aspects. Ann Surg Oncol 20(11):3504–3511. https://doi.org/10.1245/s10434-013-3039-x CrossRefPubMedPubMedCentral

71.

Oyais A, Solass W, Zieren J et al (2016) Arbeitssicherheitsaspekte der intraperitonealen Druck-Aerosol-Chemotherapie (PIPAC): bestätigung der Unbedenklichkeit (occupational health aspects of pressurised intraperitoneal aerosol chemotherapy (PIPAC): confirmation of harmlessness). Zentralblatt Chir 141(4):421–424. https://doi.org/10.1055/s-0033-1350909 CrossRef

72.

Tempfer CB, Hilal Z, Dogan A et al (2018) Concentrations of cisplatin and doxorubicin in ascites and peritoneal tumor nodules before and after pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with peritoneal metastasis. Eur J Surg Oncol (in press)

73.

Giger-Pabst U, Tempfer CB (2018) How to perform safe and technically optimized pressurized intraperitoneal aerosol chemotherapy (PIPAC): experience after a consecutive series of 1200 cases. J Surg Onc (in press)

74.

Tempfer CB, Giger-Pabst U, Seebacher V, Petersen M, Dogan A, Rezniczek GA (2018) A phase I, single-arm, open-label, dose escalation study of intraperitoneal cisplatin and doxorubicin in patients with recurrent ovarian cancer and peritoneal carcinomatosis. Gynecol Oncol pii: S0090-8258(18)30851-5. https://doi.org/10.1016/j.ygyno.2018.05.001 [Epub ahead of print]

75.

Giger-Pabst U, Demtröder C, Falkenstein TA et al (2018) Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for the treatment of malignant mesothelioma. BMC Cancer 18(1):442CrossRefPubMedPubMedCentral

76.

Struller F, Horvath P, Solass W et al (2017) Pressurized intraperitoneal aerosol chemotherapy with low-dose cisplatin and doxorubicin (PIPAC C/D) in patients with gastric cancer and peritoneal metastasis (PIPAC-GA1). J Clin Oncol 35(4_suppl):99. https://doi.org/10.1200/jco.2017.35.4_suppl.99 CrossRef

77.

Graversen M, Detlefsen S, Bjerregaard J et al (2018) Prospective, single-center implementation and response evaluation of pressurized intraperitoneal aerosol chemotherapy (PIPAC) for peritoneal metastasis. Ther Adv Med Oncol (in press)

78.

Robella M, Vaira M, Borsano A et al (2018) Feasibility, efficacy, and safety of PIPAC with oxaliplatin, cisplatin, and doxorubicin in patients with peritoneal carcinomatosis from colorectal, ovarian, gastric cancers, and primary cancers of the peritoneum: an open-label, single-arm, phase II clinical trial. In: International symposium on regional cancer therapies of the society of surgical oncology; Jacksonville, FL; Feb 17–19

79.

Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF) S3-Leitlinie Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren: Kurzversion 2.1 (2017) AWMF-Registrierungsnummer: 032-035OL

Title: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for peritoneal carcinomatosis: systematic review of clinical and experimental evidence with special emphasis on ovarian cancer
Authors: Clemens Tempfer
Urs Giger-Pabst
Ziad Hilal
Askin Dogan
Günther A. Rezniczek
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 2/2018
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-018-4784-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for peritoneal carcinomatosis: systematic review of clinical and experimental evidence with special emphasis on ovarian cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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