newsAdvanced cancer is often accompanied by multiple metastases, severely threatening patients' quality of life and survival. As medical technology continues to advance, diagnostic and therapeutic approaches for advanced metastatic disease are constantly being innovated.
Recently, the Department of General Surgery and Oncology Department II at Guangdong Pharmaceutical University Guangzhou Fosun Chancheng Hospital (Guangzhou Xinshi Hospital) successfully performed the hospital's first Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) for a patient with colon cancer and multiple peritoneal metastases. This breakthrough brings a new treatment option for patients with advanced peritoneal metastatic cancer in the region.
First Case in the Hospital: New Treatment Option for Advanced Metastatic Cancer Patients
66-year-old Madam Ma (pseudonym) had experienced recurrent advanced colon cancer with secondary metastases to the liver, lungs, and ovaries. After years of battling the disease, she suffered from severe sleep and appetite disturbances, significant malnutrition, and constant dizziness and fatigue—drained of all vitality.
With a glimmer of hope, Madam Ma's family learned that the oncology and general surgery teams at the hospital had made progress in treating advanced peritoneal metastasis and sought care there. Following comprehensive evaluation by both departmental teams, they decided to attempt PIPAC—a cutting-edge technology—for Madam Ma.
On the day of surgery, under laparoscopic guidance, Director Zhang Yin and the Oncology Department II team made two small incisions approximately 5 mm in diameter in Madam Ma's abdomen. Carbon dioxide was then introduced to establish a pressurized environment, and chemotherapy drugs were converted into aerosol particles smaller than 30 micrometers using specialized equipment, uniformly sprayed like "mist" onto the tumor surfaces within the abdominal cavity. After nebulization, the pressurized pneumoperitoneum was maintained to ensure thorough drug infiltration of the peritoneal metastatic lesions.
(Director Zhang Yin performing surgery)
The entire procedure lasted approximately one hour. Postoperatively, Madam Ma recovered well and was able to engage in light ambulation the following day. She reflected: "This treatment was much more comfortable—I didn't experience the vomiting and sleep problems like before."
PIPAC: Benefiting More Advanced Cancer Patients
Director Zhang Yin explained that compared to conventional treatments, PIPAC achieves more uniform drug distribution within the abdominal cavity, deeper penetration into solid tumors, and higher tissue drug concentrations.[1] Moreover, it uses lower dosages than systemic chemotherapy, resulting in reduced gastrointestinal side effects,[2] making it particularly suitable for patients with advanced metastatic disease or chemotherapy resistance. "Currently, Madam Ma's metastatic lesions are under control. We will conduct close follow-up and adjust the treatment plan based on evaluation results."
The successful completion of this first PIPAC procedure marks the hospital's Oncology Center and Minimally Invasive Surgery Center entering the international advanced ranks in advanced cancer treatment. This not only brings new hope for patients like Madam Ma but also means that more patients suffering from advanced peritoneal metastatic cancer will have the opportunity to benefit in the future.
Looking ahead, the hospital will continue to uphold the philosophy of combining advanced technology with humanistic care, using expertise and compassion to pave a path of hope for more patients in difficult circumstances.
Further Reading: Who is suitable for PIPAC treatment?
Patients with metastatic lesions that remain unresectable after systemic chemotherapy; patients demonstrating resistance to chemotherapy regimens; patients unsuitable for CRS/HIPEC (Cytoreductive Surgery/Hyperthermic Intraperitoneal Chemotherapy); and as neoadjuvant treatment prior to CRS/HIPEC.
References:
[1] Research Progress on Pressurized Intraperitoneal Aerosol Chemotherapy for Peritoneal Metastasis of Colorectal Cancer [J]. Chinese Journal of Clinical Oncology. (2023)
[2] Research Progress on Pressurized Intraperitoneal Aerosol Chemotherapy for Peritoneal Metastasis of Gastric Cancer [J]. Chinese Journal of Clinical Oncology. (2021)