Consensus guidelines for pressurized intraperitoneal aerosol chemotherapy: Technical aspects and treatment protocols

Hubner, M; Alyami, M; Villeneuve, L; Cortes-Guiral, D; Nowacki, M; So, J; Sgarbura, O; ISSPP PIPAC study group

Author(s): Hubner, M; Alyami, M; Villeneuve, L; Cortes-Guiral, D; Nowacki, M; So, J; Sgarbura, O; ISSPP PIPAC study group;
Details: Publication Year 2022-04,Volume 48,Issue #4,Page 789-794
Journal Title: European Journal of Surgical Oncology
Publication Type: Research article
Abstract: BACKGROUND: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is increasingly used to treat patients with peritoneal cancer. A recent survey demonstrated considerable diversification of current practice of PIPAC raising issues of concern also regarding safety and efficacy. The study aim was to reach consensus on best practice of PIPAC treatment. METHODS: Current practice was critically discussed during an expert meeting and the available evidence was scrutinized to elaborate a 33-item closed-ended questionnaire. All active PIPAC centers were then invited to participate in an online two-round Delphi process with 3 reminders at least. Consensus was defined a priori as >70% agreement for a minimal response rate of 70%. RESULTS: Forty-nine out of 57 invited PIPAC centers participated in Delphi 1 and 2 (86%). Overall, there was agreement for 21/33 items. Consensus was reached for important aspects like advanced OR ventilation system (91.8%), remote monitoring (95.9%), use of the PRGS (85.7%) and use of a safety checklist (98%). The drug regimens oxaliplatin (87.8%) and cisplatin/doxorubicin (81.6%) were both confirmed by the expert panel. Important controversies included number and location of Biopsies during repeated PIPAC and the combination of PIPAC with additional surgical procedures. CONCLUSION: This consensus statement aims to allow for safe and efficacious PIPAC treatment and to facilitate multi-center analyses of the results. Additional preclinical and clinical studies are needed to resolve the remaining controversies.
Keywords: Aerosols/therapeutic use; *Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Cisplatin; Humans; Oxaliplatin; *Peritoneal Neoplasms/drug therapy; Indications; Pipac; Safety; Technique; Treatment protocol
Department(s): Surgical Oncology
PubMed ID: 34785087
Publisher's Version: https://doi.org/10.1016/j.ejso.2021.10.028
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-12-13 04:26:01

Last Modified: 2024-12-13 04:27:13