Background Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a novel technique of intraperitoneal chemotherapy.\nFirst results obtained with PIPAC in patients with advanced peritoneal metastasis (PM) from gastric cancer\n(GC) are presented.\nMethods Retrospective analysis: Sixty PIPAC were applied in 24 consecutive patients with PM from GC. 67 % patients\nhad previous surgery, and 79 % previous platinum-based systemic chemotherapy. Mean Peritoneal Carcinomatosis Index\n(PCI) of 16Ã?±10 and 18/24 patients had signet-ring GC. Cisplatin 7.5 mg/m2 and doxorubicin 1.5 mg/m2 were given for\n30 min at 37 Ã?°C and 12 mmHg at 6 week intervals. Outcome criteria were survival, adverse events, and histological\ntumor response.\nResults Median follow-up was 248 days (range 105ââ?¬â??748), and median survival time was 15.4 months. Seventeen patients had\nrepeated PIPAC, and objective tumor response was observed in 12 (12/24=50 %): no vital tumor cells=6, major pathological resp minor resp Postoperative adverse events>CTCAE 2 were observed in 9 patients (9/24, 37.5 %). In 3/17\npatients, a later PIPAC could not be performed due to non-access. Two patients (ECOG 3 and 4) died in the hospital due to disease\nprogression.\nConclusion PIPAC with low-dose cisplatin and doxorubicin was safe and induced objective tumor regression in selected patients\nwith PM from recurrent, platinum-resistant GC. First survival data are encouraging and justify further clinical studies in this\nindication.
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