Practice of using intraperitoneal aerosol chemotherapy under pressurization for palliative treatment of pancreatic cancer

Objective: To investigate the potential of pressurized intraperitoneal aerosol chemotherapy (PIPAC) as a palliative treatment option for patients with peritoneal metastatic disease. Materials and Methods: This review covers recent advances in the use of PIPAC in the treatment of pancreatic cancer, including the pharmacokinetic characteristics of the method, the drugs used, clinical outcomes and safety profile. Results: Pancreatic cancer is one of the most aggressive malignancies, making its prognosis poor when it spreads to the peritoneum. Tumor spread to the peritoneum limits the effectiveness of standard therapies and systemic chemotherapy. Therefore, alternative locoregional treatments are needed. PIPAC is an innovative method involving laparoscopic administration of chemotherapy drugs as an aerosol into the abdominal cavity. This allows for increased local drug concentrations and reduced systemic toxicity. The authors emphasize the importance of further prospective studies to clarify indications and optimize treatment protocols, ensuring longer-term disease control with an acceptable toxicity profile. Conclusion: Pressurized intraperitoneal aerosol chemotherapy holds significant potential for the palliative treatment of pancreatic cancer, particularly when tumors extend into the peritoneum. However, further studies are needed to confirm its efficacy before this method can be implemented into clinical practice. It is also important to develop clear, multidisciplinary protocols for patient selection.