Intraperitoneal pressure aerosol chemotherapy for ovarian cancer carcinomatosis

Peritoneal metastases (PM) remain a difficult therapeutic problem with an unfavorable prognosis, mainly due to a poor response to systemic chemotherapy. Intraperitoneal chemotherapy is proposed as an alternative therapeutic method to increase the concentration of the drug in tissues and reduce systemic toxicity. Intraperitoneal pressure aerosol chemotherapy (PIPAC) was introduced in 2011 as an innovative method of intraperitoneal drug delivery in several experimental and clinical studies. As a result, the uncomplicated pilot mastered a combination of methods, the only name of which is “therapeutic pneumoperitoneum”, performed on a pipeline (pressurized intraperitoneal aerosol chemotherapy). In fact, the standard treatment consists of three PIPAC procedures scheduled every 4-6 weeks in combination with systemic chemotherapy, and can be performed depending on tolerability and response to treatment. Prospective and retrospective cohort studies show good tolerability of repeated treatment of PIPAC and rare occurrence of intraoperative and postoperative complications. This study conducted a systematic review to assess the feasibility, safety, and effectiveness of PIPAC.