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Patient-reported outcomes during repetitive oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy for isolated unresectable colorectal peritoneal metastases in a multicenter, single-arm, phase 2 trial (CRC-PIPAC).

Authors :
Lurvink, Robin J.
Rovers, Koen P.
Wassenaar, Emma C. E.
Bakkers, Checca
Burger, Jacobus W. A.
Creemers, Geert-Jan M.
Los, Maartje
Mols, Floortje
Wiezer, Marinus J.
Nienhuijs, Simon W.
Boerma, Djamila
de Hingh, Ignace H. J. T.
Source :
Surgical Endoscopy & Other Interventional Techniques; Jun2022, Vol. 36 Issue 6, p4486-4498, 13p
Publication Year :
2022

Abstract

<bold>Background: </bold>CRC-PIPAC prospectively assessed repetitive oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (PIPAC-OX) as a palliative monotherapy (i.e., without concomitant systemic therapy in between subsequent procedures) for unresectable colorectal peritoneal metastases (CPM). The present study explored patient-reported outcomes (PROs) during trial treatment.<bold>Methods: </bold>In this single-arm phase 2 trial in two tertiary centers, patients with isolated unresectable CPM received 6-weekly PIPAC-OX (92 mg/m2). PROs (calculated from EQ-5D-5L, and EORTC QLQ-C30 and QLQ-CR29) were compared between baseline and 1 and 4 weeks after the first three procedures using linear mixed modeling with determination of clinical relevance (Cohen's D ≥ 0.50) of statistically significant differences.<bold>Results: </bold>Twenty patients underwent 59 procedures (median 3 [range 1-6]). Several PROs solely worsened 1 week after the first procedure (index value - 0.10, p < 0.001; physical functioning - 20, p < 0.001; role functioning - 27, p < 0.001; social functioning - 18, p < 0.001; C30 summary score - 16, p < 0.001; appetite loss + 15, p = 0.007; diarrhea + 15, p = 0.002; urinary frequency + 13, p = 0.004; flatulence + 13, p = 0.001). These PROs returned to baseline at subsequent time points. Other PROs worsened 1 week after the first procedure (fatigue + 23, p < 0.001; pain + 29, p < 0.001; abdominal pain + 32, p < 0.001), second procedure (fatigue + 20, p < 0.001; pain + 21, p < 0.001; abdominal pain + 20, p = 0.002), and third procedure (pain + 22, p < 0.001; abdominal pain + 22, p = 0.002). Except for appetite loss, all changes were clinically relevant. All analyzed PROs returned to baseline 4 weeks after the third procedure.<bold>Conclusions: </bold>Patients receiving repetitive PIPAC-OX monotherapy for unresectable CPM had clinically relevant but reversible worsening of several PROs, mainly 1 week after the first procedure.<bold>Trial Registration: </bold>Clinicaltrials.gov: NCT03246321; Netherlands trial register: NL6426. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
18666817
Volume :
36
Issue :
6
Database :
Complementary Index
Journal :
Surgical Endoscopy & Other Interventional Techniques
Publication Type :
Academic Journal
Accession number :
156759831
Full Text :
https://doi.org/10.1007/s00464-021-08802-6