Pressurized intraperitoneal aerosolized chemotherapy clinical efficacy in the combined treatment of newly diagnosed ovarian cancer with peritoneal carcinomatosis and ascites
https://doi.org/10.17709/2410-1893-2024-11-4-3
EDN: WYABNK
Abstract
Purpose of the study. To study the clinical efficacy of pressurized intraperitoneal aerosolized chemotherapy (PIPAC), which complements the combined treatment of ovarian cancer with peritoneal carcinomatosis.
Patients and methods. The study included 175 patients with newly diagnosed ovarian cancer with peritoneal carcinomatosis (87 in the main group, 88 in the control group). All patients underwent extirpation of the uterus with appendages, removal of the large omentum and chemotherapy according to the TC scheme (Taxol, Carboplatin). In the main group, 3 additional sessions of PIPAC were performed. The duration of relapse‑free survival, PCI index, ascites volume and peritoneal morphology were evaluated.
Results. Complete regression of carcinomatosis was noted in the second session of PIPAC, in 44 (52.4 %) patients (PCI = 0); complete resorption of ascites – in 74 (88.1 %); complete therapeutic pathomorphosis – in 48 (57.2 %) cases. Complete regression of carcinomatosis was noted in the third session of PIPAC in 73 cases (87.0 %), complete resorption of ascites in 80 cases (95.2 %), complete morphological pathomorphosis in 69 cases (82.2 %). 6 months after treatment, complete regression of carcinomatosis (PCI = 0) was detected in 81 patients (96.4 %), complete resorption of ascites in 83 (98.8 %), complete morphological regression in 72 (85.7 %). The advantage of the main group in terms of median relapse‑free survival was 7 months.
Conclusion. Ascites resorption, a decrease in the PCI index and drug pathomorphosis of peritoneal metastases, detected during the 2nd session of PIPAC, had an increasing dynamics during treatment and persisted for a long time. From our point of view, the advantage in median relapse‑free survival in the main group is due to the local effect of PIPAC, which complemented the standard treatment of ovarian cancer with peritoneal carcinomatosis.
Keywords
ovarian cancer,
pressurized intraperitoneal aerosolized chemotherapy,
peritoneal carcinomatosis,
peritoneal carcinomatosis index,
drug pathomorphosis
Supporting agencies: this work was not funded.
About the Authors
A. S. Dzasochov
https://gbuzmood.ru
Moscow Regional Oncological Dispensary
Moscow Regional Oncological Dispensary
Balashikha, Russian Federation
Aleksey S. Dzasochov – Cand. Sci. (Med.), Head of the Oncogynecology Department of the Moscow Regional Oncological Dispensary, Balashikha, Russian Federation ORCID: https://orcid.org/0000-0003-4977-3533, SPIN: 9396-9145, AuthorID: 687196
Competing Interests:
Professor Andrey A. Kostin, MD, Corresponding Member of the Russian Academy of Sciences, is the Deputy Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
A. A. Kostin
https://www.rudn.ru
Peoples’ Friendship University of Russia;
Peoples’ Friendship University of Russia;
National Medical Research Radiological Centre
Moscow, Russian Federation
Andrey А. Kostin – Corresponding Member of RAS, Dr. Sci. (Med.)., Professor of the RAS, First Vice–Rector – Vice‑Rector for Research, Peoples’ Friendship University of Russia, Moscow, Russian Federation; Head of the Department of Urology and Operative Nephrology with a course in Oncourology of the Medical Institute, Peoples’ Friendship University of Russia, Moscow, Russian Federation; Leading Researcher at the National Medical Research Radiological Centre, Ministry of Health of the Russian Federation, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0002-0792-6012, SPIN: 8073‑0899, AuthorID: 193454, Scopus Author ID: 16175361500
Competing Interests:
Professor Andrey A. Kostin, MD, Corresponding Member of the Russian Academy of Sciences, is the Deputy Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and the author of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
V. L. Astashov
https://gbuzmood.ru
Moscow Regional Oncological Dispensary
Moscow Regional Oncological Dispensary
Balashikha, Russian Federation
Vladimir L. Astashov – Dr. Sci. (Med.), Professor, Chief Physician, Moscow Regional Oncological Dispensary, Balashikha, Russian Federation ORCID: https://orcid.org/0000-0003-1075-3797, SPIN: 2917-3217, AuthorID: 1084592
Competing Interests:
Professor Andrey A. Kostin, MD, Corresponding Member of the Russian Academy of Sciences, is the Deputy Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
M. A. Andreeva
https://gbuzmood.ru
Moscow Regional Oncological Dispensary
Moscow Regional Oncological Dispensary
Balashikha, Russian Federation
Marina А. Andreeva – Head of the Pathology Department, Moscow Regional Oncological Dispensary, Balashikha, Russian Federation
Competing Interests:
Professor Andrey A. Kostin, MD, Corresponding Member of the Russian Academy of Sciences, is the Deputy Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
A. B. Turiev
https://gbuzmood.ru
Moscow Regional Oncological Dispensary
Moscow Regional Oncological Dispensary
Balashikha, Russian Federation
Artur V. Turiev – MD, Oncologist of Oncogynecological Department, Moscow Regional Oncological Dispensary, Balashikha, Russian Federation ORCID: https://orcid.org/0000‑0001‑9284‑4873, SPIN: 5505‑0498, AuthorID: 610061
Competing Interests:
Professor Andrey A. Kostin, MD, Corresponding Member of the Russian Academy of Sciences, is the Deputy Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
N. Yu. Urazovskii
https://gbuzmood.ru
Moscow Regional Oncological Dispensary
Moscow Regional Oncological Dispensary
Balashikha, Russian Federation
Nikolai Yu. Urazovskii – Deputy Chief Medical Officer, Moscow Regional Oncological Dispensary, Balashikha, Russian Federation
Competing Interests:
Professor Andrey A. Kostin, MD, Corresponding Member of the Russian Academy of Sciences, is the Deputy Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
References
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin (2021) 71:209–249. doi: 10.3322/caac.21660
2. Ovarian cancer, fallopian tube cancer, primary peritoneal cancer. Clinical recommendations. Мoscow, 2020. Available at: https://oncology.ru/specialist/treatment/references/actual/547.pdf Accessed: 29. 11. 2024
3. Hamanishi J, Takeshima N, Katsumata N, Kimio U, Kimura T, Takeuchi S, et al. Nivolumab Versus Gemcitabine or Pegylated Liposomal Doxorubicin for Patients With Platinum‑Resistant Ovarian Cancer: Open‑Label, Randomized Trial in Japan (NINJA). J Clin Oncol. 2021 Nov 20;39(33):3671–3681. doi: 10.1200/jco.21.00334
4. Moore KN, Bookman M, Sehouli J, Miller A, Anderson C, Scambia G, et al. Atezolizumab, bevacizumab, and chemotherapy for newly diagnosed stage III or IV ovarian cancer: placebo‑controlled randomized phase III trial (IMagyn050/GOG 3015/ ENGOT‑OV39). J Clin Oncol. 2021 Jun 10;39(17):1842–1855. doi: 10.1200/jco.21.00306
5. Monk BJ, Colombo N, Oza AM, Fujiwara K, Birrer MJ, Randall L, et al. Chemotherapy with or without avelumab followed by avelumab maintenance versus chemotherapy alone in patients with previously untreated epithelial ovarian cancer (JAVELIN ovarian 100): an open‑label, randomised, phase 3 trial. Lancet Oncol. 2021 Sep;22(9):1275–1289. doi: 10.1016/s1470‑2045(21)00342‑9
6. Pujade‑Lauraine E, Fujiwara K, Ledermann JA, Oza AM, Kristeleit R, RayCoquard IL, et al. Avelumab alone or in combination with chemotherapy versus chemotherapy alone in platinum‑resistant or platinum‑refractory ovarian cancer (JAVELIN ovarian 200): an open‑label, three‑arm, randomised, phase 3 study. Lancet Oncol. 2021 Jul;22(7):1034–1046. doi: 10.1016/s1470‑2045(21)00216‑3
7. Lim MC, Chang SJ, Park B, Yoo HJ, Yoo CW, Nam BH, et al. Survival after hyperthermic intraperitoneal chemotherapy and primary or interval cytoreductive surgery in ovarian cancer: a randomized clinical trial. JAMA Surg. 2022 May 1;157(5):374–383. doi: 10.1001/jamasurg.2022.0143
8. Reymond MA, Hu B, Garcia A, Reck T, Köckerling F, Hess J, Morel P. Feasibility of therapeutic pneumoperitoneum in a large animal model using a microvaporisator. Surg Endosc. 2000 Jan;14(1):51–55. doi: 10.1007/s004649900010
9. Odendahl K, Solass W, Demtröder C, Giger‑Pabst U, Zieren J, Tempfer C, Reymond MA. Quality of life of patients with end‑stage peritoneal metastasis treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC). Eur J Surg Oncol. 2015 Oct;41(10):1379–1385. doi: 10.1016/j.ejso.2015.06.001
10. Gombolevsky VA, Vaypan ASh, Shapiev AN, Vladzimirsky AV, Morozov SP. Application of criteria for the response of solid tumors to chemotherapeutic treatment (RECIST 1.1). Moscow, 2018, 15 p.
Review
For citations:
Dzasochov A.S., Kostin A.A., Astashov V.L., Andreeva M.A., Turiev A.B., Urazovskii N.Yu. Pressurized intraperitoneal aerosolized chemotherapy clinical efficacy in the combined treatment of newly diagnosed ovarian cancer with peritoneal carcinomatosis and ascites. Research and Practical Medicine Journal. 2024;11(4):36-45. (In Russ.) https://doi.org/10.17709/2410-1893-2024-11-4-3. EDN: WYABNK
Views:
286
Email this article 