ABSTRACT
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) relies on logical physical principles: local administration into the body cavity to improve therapeutic ratio, gaseous form to achieve homogeneous drug distribution, pressure application to enhance convective drug uptake into tumor nodes, and minimally invasive approach to minimize operative trauma. PIPAC allows repeated therapy cycles and objective tumor response assessment. PIPAC technology differs from usual aerosol can technology. Preclinical and clinical data support the superior distribution of a staining and/or therapeutic substance within the abdominal cavity after PIPAC. The likelihood exists that much of the residual tumor burden after surgery is untreated or undertreated by conventional intraperitoneal irrigation. PIPAC can be applied several times without any relevant organ toxicities. This is indeed an important feature for developing effective locoregional chemotherapy regimen including several cycles and is a clear advantage over hyperthermic intraperitoneal chemotherapy, for which repeated application is exceptional.
