What is long-term survival in patients with peritoneal metastasis from gastric, pancreatic, or colorectal cancer? A study of patients treated with systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC)

IF 1.4 Q4 ONCOLOGY Pleura and Peritoneum Pub Date : 2023-12-01 DOI:10.1515/pp-2023-0038
Charlotte G. Kryh-Jensen, C. Fristrup, Alan P. Ainsworth, S. Detlefsen, Michael B. Mortensen, Per Pfeiffer, L. Tarpgaard, M. Graversen
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Abstract

Abstract Objectives A definition of long-term survival (LTS) in patients with peritoneal metastasis (PM) from gastric cancer (GC), pancreatic cancer (PC) or colorectal cancer (CRC) treated with systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC) is lacking. We aimed to define LTS and investigate characteristics and treatment response in patients who reached LTS in data from two prospective trials. Methods Retrospective study of patients with GC-, PC-, or CRC-PM from the prospective PIPAC-OPC1 and PIPAC-OPC2 studies. The definition of LTS was based on published systematic reviews and randomized controlled trials. LTS was defined at the time point where 25 % of the patients were alive in these studies. Histology based response was evaluated by the mean Peritoneal Regression Grading Score (PRGS) using biopsies obtained prior to PIPAC 3, and defined by a mean PRGS of ≤2.0 or a decrease of mean PRGS of ≥1, compared to baseline. Results LTS was defined at 21 (GC), 15 (PC), and 24 (CRC) months. Fifty-one (47.2 %) patients (nine GC, 17 PC, 25 CRC) reached LTS calculated from the date of PM diagnosis. All but one received palliative chemotherapy before PIPAC, and 37 % received bidirectional treatment. More than 90 % of the LTS patients had response according to PRGS. The mOS from PIPAC 1 was 23.3, 12.4, and 28.5 months for GC, PC, and CRC LTS patients. Conclusions Patients with PM from GC, PC, and CRC treated with systemic chemotherapy and PIPAC can reach LTS and most show histological response. Causality must be further investigated.
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胃癌、胰腺癌或结直肠癌腹膜转移患者的长期生存率如何?对接受全身化疗和腹腔内加压气溶胶化疗 (PIPAC) 患者的研究
摘要 目的 缺乏对胃癌(GC)、胰腺癌(PC)或结直肠癌(CRC)腹膜转移(PM)患者接受全身化疗和加压腹腔内气溶胶化疗(PIPAC)后长期生存(LTS)的定义。我们旨在定义LTS,并调查两项前瞻性试验数据中达到LTS的患者的特征和治疗反应。方法 对前瞻性 PIPAC-OPC1 和 PIPAC-OPC2 研究中的 GC、PC 或 CRC-PM 患者进行回顾性研究。LTS 的定义基于已发表的系统综述和随机对照试验。在这些研究中,LTS 的定义为 25% 的患者存活的时间点。组织学反应根据 PIPAC 3 之前获得的活组织切片的平均腹膜回归分级评分(PRGS)进行评估,平均 PRGS 与基线相比≤2.0 或平均 PRGS 降低≥1。结果 LTS 的定义时间分别为 21 个月(GC)、15 个月(PC)和 24 个月(CRC)。51例(47.2%)患者(9 例 GC、17 例 PC、25 例 CRC)从 PM 诊断之日起计算达到了 LTS。除一名患者外,其他患者均在 PIPAC 前接受了姑息化疗,37% 的患者接受了双向治疗。根据 PRGS,90% 以上的 LTS 患者有反应。GC、PC 和 CRC LTS 患者自 PIPAC 1 起的生存期分别为 23.3 个月、12.4 个月和 28.5 个月。结论 接受全身化疗和 PIPAC 治疗的 GC、PC 和 CRC PM 患者可达到 LTS,且大多数患者表现出组织学反应。其因果关系有待进一步研究。
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来源期刊
CiteScore
2.50
自引率
11.10%
发文量
23
审稿时长
9 weeks
期刊最新文献
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