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Consensus guidelines for pressurized intraperitoneal aerosol chemotherapy: Technical aspects and treatment protocols
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 cons...
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Published in: | European journal of surgical oncology 2022-04, Vol.48 (4), p.789-794 |
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creator | Hübner, Martin Alyami, Mohammad Villeneuve, Laurent Cortés-Guiral, Delia Nowacki, Maciej So, Jimmy Sgarbura, Olivia Abba, Julio Afifi, Adnane Mortensen, Michael Bau Bhatt, Aditi Brandl, Andreas Ceelen, Wim Coget, Julien Courvoiser, Thomas de Hingh, Ignace H. Delhorme, Jean-Baptiste di Giorgio, Andrea Dumont, Frederic Escayola, Cecilia Eveno, Clarisse Ezanno, Anne-Cécile Gagnière, Johan Galindo, Julio Glatz, Torben Glehen, Olivier Jäger, Tarkan Kepenekian, Vahan Khomyakov, Vladimir M. Kothonidis, Konstantinos Lehmann, Kuno Lynch, Craig Mehta, Sanket Moldovan, Bogdan Nissan, Aviram Orry, David Pérez, Gloria Ortega Paquette, Brice Paskonis, Marius Piso, Pompiliu Pocard, Marc Rau, Beat Robella, Manuela Singh, Shivendra Somashekhar, S.P. Soravia, Claudio Taibi, Abelkader Torkington, Jared Vizzielli, Giuseppe Willaert, Wouter |
description | 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.
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%.
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.
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. |
doi_str_mv | 10.1016/j.ejso.2021.10.028 |
format | article |
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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%.
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.
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.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2021.10.028</identifier><identifier>PMID: 34785087</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aerosols - therapeutic use ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Cisplatin ; Humans ; Indications ; Oxaliplatin ; Peritoneal Neoplasms - drug therapy ; PIPAC ; Safety ; Technique ; Treatment protocol</subject><ispartof>European journal of surgical oncology, 2022-04, Vol.48 (4), p.789-794</ispartof><rights>2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><rights>Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c286t-65f7c6c5b815c66836420e048cb4eb89ff3063baec86d17ec5f8fa8d37003f313</citedby><cites>FETCH-LOGICAL-c286t-65f7c6c5b815c66836420e048cb4eb89ff3063baec86d17ec5f8fa8d37003f313</cites><orcidid>0000-0002-0040-8511</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34785087$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hübner, Martin</creatorcontrib><creatorcontrib>Alyami, Mohammad</creatorcontrib><creatorcontrib>Villeneuve, Laurent</creatorcontrib><creatorcontrib>Cortés-Guiral, Delia</creatorcontrib><creatorcontrib>Nowacki, Maciej</creatorcontrib><creatorcontrib>So, Jimmy</creatorcontrib><creatorcontrib>Sgarbura, Olivia</creatorcontrib><creatorcontrib>Abba, Julio</creatorcontrib><creatorcontrib>Afifi, Adnane</creatorcontrib><creatorcontrib>Mortensen, Michael Bau</creatorcontrib><creatorcontrib>Bhatt, Aditi</creatorcontrib><creatorcontrib>Brandl, Andreas</creatorcontrib><creatorcontrib>Ceelen, Wim</creatorcontrib><creatorcontrib>Coget, Julien</creatorcontrib><creatorcontrib>Courvoiser, Thomas</creatorcontrib><creatorcontrib>de Hingh, Ignace H.</creatorcontrib><creatorcontrib>Delhorme, Jean-Baptiste</creatorcontrib><creatorcontrib>di Giorgio, Andrea</creatorcontrib><creatorcontrib>Dumont, Frederic</creatorcontrib><creatorcontrib>Escayola, Cecilia</creatorcontrib><creatorcontrib>Eveno, Clarisse</creatorcontrib><creatorcontrib>Ezanno, Anne-Cécile</creatorcontrib><creatorcontrib>Gagnière, Johan</creatorcontrib><creatorcontrib>Galindo, Julio</creatorcontrib><creatorcontrib>Glatz, Torben</creatorcontrib><creatorcontrib>Glehen, Olivier</creatorcontrib><creatorcontrib>Jäger, Tarkan</creatorcontrib><creatorcontrib>Kepenekian, Vahan</creatorcontrib><creatorcontrib>Khomyakov, Vladimir M.</creatorcontrib><creatorcontrib>Kothonidis, Konstantinos</creatorcontrib><creatorcontrib>Lehmann, Kuno</creatorcontrib><creatorcontrib>Lynch, Craig</creatorcontrib><creatorcontrib>Mehta, Sanket</creatorcontrib><creatorcontrib>Moldovan, Bogdan</creatorcontrib><creatorcontrib>Nissan, Aviram</creatorcontrib><creatorcontrib>Orry, David</creatorcontrib><creatorcontrib>Pérez, Gloria Ortega</creatorcontrib><creatorcontrib>Paquette, Brice</creatorcontrib><creatorcontrib>Paskonis, Marius</creatorcontrib><creatorcontrib>Piso, Pompiliu</creatorcontrib><creatorcontrib>Pocard, Marc</creatorcontrib><creatorcontrib>Rau, Beat</creatorcontrib><creatorcontrib>Robella, Manuela</creatorcontrib><creatorcontrib>Singh, Shivendra</creatorcontrib><creatorcontrib>Somashekhar, S.P.</creatorcontrib><creatorcontrib>Soravia, Claudio</creatorcontrib><creatorcontrib>Taibi, Abelkader</creatorcontrib><creatorcontrib>Torkington, Jared</creatorcontrib><creatorcontrib>Vizzielli, Giuseppe</creatorcontrib><creatorcontrib>Willaert, Wouter</creatorcontrib><creatorcontrib>ISSPP PIPAC study group</creatorcontrib><title>Consensus guidelines for pressurized intraperitoneal aerosol chemotherapy: Technical aspects and treatment protocols</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>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.
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%.
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.
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.</description><subject>Aerosols - therapeutic use</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Cisplatin</subject><subject>Humans</subject><subject>Indications</subject><subject>Oxaliplatin</subject><subject>Peritoneal Neoplasms - drug therapy</subject><subject>PIPAC</subject><subject>Safety</subject><subject>Technique</subject><subject>Treatment protocol</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kE9v1DAQxS0EotvCF-CAcuSSxY7jP0Fc0AoKUiUu5Ww5zpj1KrEXj4PUfnocbeHIaaT33rzR_Ah5w-ieUSbfn_ZwwrTvaMeqsKedfkZ2TPCu7ZhQz8mOql63atD8ilwjniilA1fDS3LFe6UF1WpHyiFFhIgrNj_XMMEcImDjU27OGRDXHB5hakIs2Z4hh5Ii2LmxkBOmuXFHWFI5QjUfPjT34I4xuM3HM7iCjY1TUzLYskAstTGV5NKMr8gLb2eE10_zhvz48vn-8LW9-3777fDprnWdlqWVwisnnRg1E05KzWXfUaC9dmMPox6851Ty0YLTcmIKnPDaWz1xRSn3nPEb8u7SWy__WgGLWQI6mGcbIa1oOjFowXUveY12l6irn2EGb845LDY_GEbNRtuczEbbbLQ3rdKuS2-f-tdxgenfyl-8NfDxEoD65e8A2aALEB1MIVdAZkrhf_1_AGsblGU</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Hübner, Martin</creator><creator>Alyami, Mohammad</creator><creator>Villeneuve, Laurent</creator><creator>Cortés-Guiral, Delia</creator><creator>Nowacki, Maciej</creator><creator>So, Jimmy</creator><creator>Sgarbura, Olivia</creator><creator>Abba, Julio</creator><creator>Afifi, Adnane</creator><creator>Mortensen, Michael Bau</creator><creator>Bhatt, Aditi</creator><creator>Brandl, Andreas</creator><creator>Ceelen, Wim</creator><creator>Coget, Julien</creator><creator>Courvoiser, Thomas</creator><creator>de Hingh, Ignace H.</creator><creator>Delhorme, Jean-Baptiste</creator><creator>di Giorgio, Andrea</creator><creator>Dumont, Frederic</creator><creator>Escayola, Cecilia</creator><creator>Eveno, Clarisse</creator><creator>Ezanno, Anne-Cécile</creator><creator>Gagnière, Johan</creator><creator>Galindo, Julio</creator><creator>Glatz, Torben</creator><creator>Glehen, Olivier</creator><creator>Jäger, Tarkan</creator><creator>Kepenekian, Vahan</creator><creator>Khomyakov, Vladimir M.</creator><creator>Kothonidis, Konstantinos</creator><creator>Lehmann, Kuno</creator><creator>Lynch, Craig</creator><creator>Mehta, Sanket</creator><creator>Moldovan, Bogdan</creator><creator>Nissan, Aviram</creator><creator>Orry, David</creator><creator>Pérez, Gloria Ortega</creator><creator>Paquette, Brice</creator><creator>Paskonis, Marius</creator><creator>Piso, Pompiliu</creator><creator>Pocard, Marc</creator><creator>Rau, Beat</creator><creator>Robella, Manuela</creator><creator>Singh, Shivendra</creator><creator>Somashekhar, S.P.</creator><creator>Soravia, Claudio</creator><creator>Taibi, Abelkader</creator><creator>Torkington, Jared</creator><creator>Vizzielli, Giuseppe</creator><creator>Willaert, Wouter</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0040-8511</orcidid></search><sort><creationdate>202204</creationdate><title>Consensus guidelines for pressurized intraperitoneal aerosol chemotherapy: Technical aspects and treatment protocols</title><author>Hübner, Martin ; Alyami, Mohammad ; Villeneuve, Laurent ; Cortés-Guiral, Delia ; Nowacki, Maciej ; So, Jimmy ; Sgarbura, Olivia ; Abba, Julio ; Afifi, Adnane ; Mortensen, Michael Bau ; Bhatt, Aditi ; Brandl, Andreas ; Ceelen, Wim ; Coget, Julien ; Courvoiser, Thomas ; de Hingh, Ignace H. ; Delhorme, Jean-Baptiste ; di Giorgio, Andrea ; Dumont, Frederic ; Escayola, Cecilia ; Eveno, Clarisse ; Ezanno, Anne-Cécile ; Gagnière, Johan ; Galindo, Julio ; Glatz, Torben ; Glehen, Olivier ; Jäger, Tarkan ; Kepenekian, Vahan ; Khomyakov, Vladimir M. ; Kothonidis, Konstantinos ; Lehmann, Kuno ; Lynch, Craig ; Mehta, Sanket ; Moldovan, Bogdan ; Nissan, Aviram ; Orry, David ; Pérez, Gloria Ortega ; Paquette, Brice ; Paskonis, Marius ; Piso, Pompiliu ; Pocard, Marc ; Rau, Beat ; Robella, Manuela ; Singh, Shivendra ; Somashekhar, S.P. ; Soravia, Claudio ; Taibi, Abelkader ; Torkington, Jared ; Vizzielli, Giuseppe ; Willaert, Wouter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c286t-65f7c6c5b815c66836420e048cb4eb89ff3063baec86d17ec5f8fa8d37003f313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aerosols - 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Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hübner, Martin</au><au>Alyami, Mohammad</au><au>Villeneuve, Laurent</au><au>Cortés-Guiral, Delia</au><au>Nowacki, Maciej</au><au>So, Jimmy</au><au>Sgarbura, Olivia</au><au>Abba, Julio</au><au>Afifi, Adnane</au><au>Mortensen, Michael Bau</au><au>Bhatt, Aditi</au><au>Brandl, Andreas</au><au>Ceelen, Wim</au><au>Coget, Julien</au><au>Courvoiser, Thomas</au><au>de Hingh, Ignace H.</au><au>Delhorme, Jean-Baptiste</au><au>di Giorgio, Andrea</au><au>Dumont, Frederic</au><au>Escayola, Cecilia</au><au>Eveno, Clarisse</au><au>Ezanno, Anne-Cécile</au><au>Gagnière, Johan</au><au>Galindo, Julio</au><au>Glatz, Torben</au><au>Glehen, Olivier</au><au>Jäger, Tarkan</au><au>Kepenekian, Vahan</au><au>Khomyakov, Vladimir M.</au><au>Kothonidis, Konstantinos</au><au>Lehmann, Kuno</au><au>Lynch, Craig</au><au>Mehta, Sanket</au><au>Moldovan, Bogdan</au><au>Nissan, Aviram</au><au>Orry, David</au><au>Pérez, Gloria Ortega</au><au>Paquette, Brice</au><au>Paskonis, Marius</au><au>Piso, Pompiliu</au><au>Pocard, Marc</au><au>Rau, Beat</au><au>Robella, Manuela</au><au>Singh, Shivendra</au><au>Somashekhar, S.P.</au><au>Soravia, Claudio</au><au>Taibi, Abelkader</au><au>Torkington, Jared</au><au>Vizzielli, Giuseppe</au><au>Willaert, Wouter</au><aucorp>ISSPP PIPAC study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Consensus guidelines for pressurized intraperitoneal aerosol chemotherapy: Technical aspects and treatment protocols</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2022-04</date><risdate>2022</risdate><volume>48</volume><issue>4</issue><spage>789</spage><epage>794</epage><pages>789-794</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>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.
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%.
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.
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.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34785087</pmid><doi>10.1016/j.ejso.2021.10.028</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-0040-8511</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0748-7983 |
ispartof | European journal of surgical oncology, 2022-04, Vol.48 (4), p.789-794 |
issn | 0748-7983 1532-2157 |
language | eng |
recordid | cdi_proquest_miscellaneous_2598538463 |
source | Elsevier |
subjects | Aerosols - therapeutic use Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cisplatin Humans Indications Oxaliplatin Peritoneal Neoplasms - drug therapy PIPAC Safety Technique Treatment protocol |
title | Consensus guidelines for pressurized intraperitoneal aerosol chemotherapy: Technical aspects and treatment protocols |
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