Chemotherapy is currently the most widely used complement to surgery to treat most types of cancer. One of the latest innovations in this treatment is the PIPAC technique, the intraperitoneal application of an aerosolized spray.
PIPAC chemotherapy technique
The Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) technique consists of applying chemotherapeutic compounds in the form of an aerosol into the abdominal cavity by laparoscopy. The advantage of the PIPAC method is that it provides the patient with a direct administration of the chemotherapy drug and therefore more effective in cases of peritoneal carcinomatosis, with hardly any side effects, and by means of a minimal surgical intervention that allows the patient to go home the following day.
How the PIPAC technique works
Through the pressure exerted by the laparoscopic gas, the chemotherapy molecules penetrate directly into the tumor or tumor implants.
Peritoneal carcinomatosis and PIPAC technique
Peritoneal carcinomatosis is the spread of tumor nodules in the andominal cavity. A few years ago, this state of peritoneal carcinomatosis was practically incurable, synonymous with a terminal state with very low survival. But thanks to advances in surgery and chemotherapy such as intraperitoneal chemotherapy, HIPEC or PIPAC, high long-term survival rates can be achieved.
Advantages of PIPAC chemotherapy
The PIPAC technique offers better results because it is a way of administering chemotherapy directly over the tumor implants by laparoscopy, which allows better penetration of the drug into the tumor and therefore greater efficacy in the treatment.
Moreover, since the drug is not administered intravenously, side effects are practically non-existent.
The patient can leave the hospital the day after the treatment session and return to normal life. Sessions should be performed approximately every six to eight weeks until cytoreduction surgery is performed, the only treatment with curative intent that has been demonstrated to date.
The PIPAC technique makes it possible to reduce the volume of the tumor and then operate with cytoreduction surgery. In cases where the tumor is incurable, palliative treatment with the PIPAC technique offers the patient a better quality of life than with conventional intravenous chemotherapy.
Prognosis of patients treated with PIPAC
The best indication for this chemotherapy technique is for patients with unresectable peritoneal carcinomatosis, in whom it is not possible to completely resect the disease. With the PIPAC technique it is possible to reduce the tumor and thus make the patient fit for surgery or, if not, to influence a better evolution of the disease. The PIPAC chemotherapy technique is contraindicated in patients with intestinal perforation or occlusion.
Currently, the PIPAC chemotherapy technique can be performed at the Hospital El Pilar-Quirón Salud in Barcelona by the specialist in Gynecology and Obstetrics, and clinical analyses are being carried out to use this system in different tumors, as well as the application of other drugs by means of the laparoscopic PIPAC system. The most important thing for good results in these patients is that the treatment (surgery, chemotherapy or PIPAC) is performed by a professional expert in peritoneal carcinomatosis.