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Macedo et al. J Cancer Metastasis Treat 2018;4:8 Journal of Cancer
DOI: 10.20517/2394-4722.2017.72 Metastasis and Treatment

Original Article Open Access

Gastric cancer treated with pressurized
intraperitoneal aerosol chemotherapy: revising an
option for peritoneal carcinomatosis

Filipa Macedo , Kátia Ladeira 2,3,4 , Adhemar Longatto-Filho 3,4,5,6 , Sandra F. Martins 3,4,7
1
1 Portuguese Oncology Institute-Coimbra, Coimbra 3000-075, Portugal.
2 Portuguese Oncology Institute-Lisbon, Lisbon 1099-023, Portugal.
3 Life and Health Science Research Institute, School of Health Sciences, University of Minho, Braga 4710-057, Portugal.
4 ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Braga 4710-057, Portugal.
5 Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo 14784-400, Brazil.
6 Laboratory of Medical Investigation 14, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil.
7 Surgery Department, Coloproctology Unit, Braga Hospital, Braga 4710-243, Portugal.

Correspondence to: Dr. Sandra F. Martins, Life and Health Science Research Institute, School of Health Sciences, University of Minho,
Braga 4710-057, Portugal. E-mail: sandramartins@med.uminho.pt

How to cite this article: Macedo F, Ladeira K, Longatto-Filho A, Martins SF. Gastric cancer treated with pressurized intraperitoneal
aerosol chemotherapy: revising an option for peritoneal carcinomatosis. J Cancer Metastasis Treat 2018;4:8.
http://dx.doi.org/10.20517/2394-4722.2017.72

Received: 7 Nov 2017 First Decision: 28 Dec 2017 Revised: 19 Jan 2018 Accepted: 22 Jan 2018 Published: 9 Feb 2018

Science Editor: Masayuki Watanabe Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Aim: Gastric cancer is the cancer with the highest rate of peritoneal metastization and this type of spread is associated
with a higher death rate compared to distant organ metastasis. The systemic chemotherapy has a minimal effect in
peritoneal metastasis so new types of treatment have emerged. The authors revised the main studies done in pressurized
intraperitoneal aerosol chemotherapy (PIPAC) and presented the main conclusions.

Methods: A PubMed search was conducted focusing on PIPAC in gastric cancer. The MeSH database was searched with
the terms: “Gastric cancer [MeSH] and intraperitoneal aerosol chemotherapy”.

Results: Seven studies were analyzed. All the studies performed the technique with aerosol of doxorubicin and cisplatin.
All cases were well tolerated, with minor adverse effects. Patients presented resolution of their abdominal symptoms and
regression of macroscopic carcinomatosis. Cytoreductive surgery or hypertermic intraperitoneal chemotherapy could be
performed in some patients with good response to PIPAC. The peritonitis caused by the chemotherapy was well tolerated.

Conclusion: PIPAC can induce remission in end-stage and resistant disease with acceptable side effects, good safety levels
for patients and health professionals, and quality of life improvement.

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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