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

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a growing treatment for peritoneal cancer.
• Current PIPAC practices show significant variation, impacting safety and efficacy.
• A need exists to standardize PIPAC procedures for better patient outcomes.

Purpose of the Study:

• To establish a consensus on best practices for Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC).
• To address safety and efficacy concerns arising from diversified PIPAC applications.
• To provide a foundation for multi-center PIPAC treatment analyses.

Main Methods:

• A critical discussion of current practices occurred during an expert meeting.
• A 33-item closed-ended questionnaire was developed based on evidence.
• A two-round Delphi process involving active PIPAC centers was conducted.

Main Results:

• 86% of invited PIPAC centers participated in the Delphi process.
• Consensus was achieved on 21 out of 33 items, including ventilation, monitoring, and safety checklists.
• Confirmed drug regimens include oxaliplatin and cisplatin/doxorubicin, while biopsy protocols and combined procedures remain controversial.

Conclusions:

• The consensus statement promotes safe and effective PIPAC treatment.
• Standardized protocols will facilitate multi-center studies and data comparison.
• Further research is required to resolve ongoing controversies in PIPAC application.