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Background <p>Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a promising therapeutic approach for treating advanced colorectal cancer with peritoneal metastases. Herein, we conducted this meta-analysis to evaluate the feasibility, efficacy, and safety of PIPAC in this patient population.</p> Methods <p>A comprehensive literature search was performed from January 2011 to April 2024 on the following databases: PubMed, Embase, Web of Science, and the Cochrane Library, and focused on studies reporting on the feasibility, efficacy, and safety of PIPAC.</p> Results <p>Of the 354 initially identified studies, 12 were included in the meta-analysis, comprising 631 patients who underwent 1,461 PIPAC procedures. Our data analysis indicated that 44.3% of the patients completed three or more PIPAC procedures. Conversely, 9.1% of patients either did not have access to or could not undergo PIPAC. The average rate of histological response across the included studies was 69.7%. Adverse events were reported in 53.5% of patients, with 7.7% experiencing severe adverse events (grade 3–5). The pooled mortality related to PIPAC was 0.1%. The pooled proportions for 6-month, 1-year, 2-year, and 3-year overall survival rates were 86.3%, 62.0%, 32.8%, and 15.9% respectively. The average median overall survival and progression-free survival were 15.15&#xa0;months and 6.08&#xa0;months.</p> Conclusions <p>Our study suggests that relatively young patients with low PCI scores, combined chemotherapy during PIPAC treatment and without malignant ascites are the best target population for PIPAC treatment because they can achieve the lowest incidence of adverse events and the best survival.</p>

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Pressurized intraperitoneal aerosol chemotherapy in advanced colorectal cancer with peritoneal metastases: a meta-analysis of feasibility, efficacy, and safety

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Ruijian Chen,
  • Renjie Li,
  • Zifeng Yang,
  • Yong Li

摘要

Background

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a promising therapeutic approach for treating advanced colorectal cancer with peritoneal metastases. Herein, we conducted this meta-analysis to evaluate the feasibility, efficacy, and safety of PIPAC in this patient population.

Methods

A comprehensive literature search was performed from January 2011 to April 2024 on the following databases: PubMed, Embase, Web of Science, and the Cochrane Library, and focused on studies reporting on the feasibility, efficacy, and safety of PIPAC.

Results

Of the 354 initially identified studies, 12 were included in the meta-analysis, comprising 631 patients who underwent 1,461 PIPAC procedures. Our data analysis indicated that 44.3% of the patients completed three or more PIPAC procedures. Conversely, 9.1% of patients either did not have access to or could not undergo PIPAC. The average rate of histological response across the included studies was 69.7%. Adverse events were reported in 53.5% of patients, with 7.7% experiencing severe adverse events (grade 3–5). The pooled mortality related to PIPAC was 0.1%. The pooled proportions for 6-month, 1-year, 2-year, and 3-year overall survival rates were 86.3%, 62.0%, 32.8%, and 15.9% respectively. The average median overall survival and progression-free survival were 15.15 months and 6.08 months.

Conclusions

Our study suggests that relatively young patients with low PCI scores, combined chemotherapy during PIPAC treatment and without malignant ascites are the best target population for PIPAC treatment because they can achieve the lowest incidence of adverse events and the best survival.