Abstract
Background: Peritoneal carcinomatosis (PC) is a common evolution of abdominal cancers and is
associated with poor prognosis. A few selected patients have option of cytoreductive
surgery and hyperthermic intraperitoneal chemotherapy, but majority who are not eligible
for curative approach can undergo pressurized intraperitoneal aerosol chemotherapy
(PIPAC). It is an emerging field of research with major therapeutic potential. It
is a safe and innovative approach, which enhances the effect of chemotherapy without
major toxicity. Methods: Between June 2017 and December 2017, 21 PIPAC applications in seven patients with
standard chemotherapy regimen every 6 weeks at 37°C and 12 mmHg for 30 min was performed.
The patients' demographics, perioperative findings, adverse events, and outcomes were
prospectively recorded. Results: Twenty-one PIPAC administrations were performed in 7 patients with PC from various
pathologies. The median hospital stay was 1 day. All the patients had symptomatic
relief with complete resolution of ascites. There was no major perioperative complications.
CTCAE Grades 1 and 2 were observed in three patients, for abdominal pain and nausea.
Renal and hepatic functions were not impaired. Of the seven patients, one patient
had complete histological remission; three patients had partial response, one had
stable disease and one patient had no response with clinical progression. Conclusion: Our results show the feasibility and safety of PIPAC in Indian patients. The procedure
has low morbidity with no mortality with the short learning curve. It can be easily
adapted for Indian patients with diffuse PC as a palliative option apart from systemic
chemotherapy.
Key words
Chemotherapy - cytoreductive surgery - hyperthermic intraperitoneal chemotherapy -
Indian patients - intraperitoneal - peritoneal carcinomatosis - pressurized intraperitoneal
aerosol chemotherapy
