Systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC): A case report of a multimodal treatment for peritoneal metastases of pancreatic origin

Stefano Rotolo; Federica Ferracci; Francesco Santullo; Claudio Lodoli; Frediano Inzani; Carlo Abatini; Fabio Pacelli; Andrea Di Giorgio

doi:10.1016/j.ijscr.2020.10.054

Systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC): A case report of a multimodal treatment for peritoneal metastases of pancreatic origin

Int J Surg Case Rep. 2020;77S(Suppl):S75-S78. doi: 10.1016/j.ijscr.2020.10.054. Epub 2020 Oct 22.

Authors

Stefano Rotolo¹, Federica Ferracci², Francesco Santullo³, Claudio Lodoli³, Frediano Inzani⁴, Carlo Abatini³, Fabio Pacelli³, Andrea Di Giorgio³

Affiliations

¹ Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
² Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Electronic address: federica.ferracci01@icatt.it.
³ Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
⁴ Institute of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Abstract

Introduction: Pancreatic ductal adenocarcinoma (PDAC) with peritoneal metastases (PM) has a dismal prognosis and palliative systemic chemotherapy, which represents the standard treatment option, has significant pharmacokinetics limitations and low efficacy. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new method of drug delivery that is expected to maximize exposure of peritoneal nodules to antiblastic agents. A combination of systemic chemotherapy and PIPAC may be valuable.

Presentation of case: A 55 years old male affected by PDAC with synchronous PM underwent a multimodal treatment comprising systemic chemotherapy and PIPAC without any procedural-related adverse events. Tumor genomic profiling evaluation from peritoneal biopsies addressed further tailored systemic chemotherapy.

Discussion: The presented case illustrates the possibility of adding PIPAC to systemic chemotherapy with a fair tolerance profile and good quality of life while allowing monitoring of therapy-response and tailoring of the antiblastic treatment.

Keywords: Carcinomatosis; Pancreatic ductal adenocarcinoma; Peritoneal metastases; Pressurized intraperitoneal aerosol chemotherapy (PIPAC).

Publication types

Case Reports