Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in treatment of advanced ovarian cancer. A review of the literature

Objective: The majority of advanced ovarian cancer (OC) patients do not fully respond to systemic chemotherapy, thus complete cytoreduction can not be achieved in such cases. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been suggested as an alternative approach for these women. Our study aimed to review the literature regarding the application of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in OC patients with peritoneal carcinomatosis (PC). Data source: Articles in the English language were searched in PubMed. Search terms included “PIPAC” and “ovarian cancer”. Methods of study selection: The authors evaluated all studies presenting an application of pressurised intraperitoneal aerosol chemotherapy (PIPAC) on ovarian cancer patients. The published guidelines for Systematic Reviews and Meta-analyses (PRISMA) were followed in the present systematic review which was performed based on the authors’ predetermined inclusion criteria. Tabulation: Table 1 presents the main characteristics and outcomes of the OC patients undergoing PIPAC. Integration: Study selection and data extraction were independently undertaken by two reviewers. Results: 235 patients from 15 studies retrieved from PubMed were included. Conclusions: Our results indicate that PIPAC is efficient and safe in selected OC patients with PC not responding to systemic chemotherapy. The toxicity is manageable and the quality of life sustained. Further, randomised controlled trials are warranted to confirm our findings.