PIPAC stands for Pressurised Intra Peritoneal Aerosolised Chemotherapy. It is a specialised delivery system in which aerosolised chemotherapy is delivered under pressure into the abdominal cavity. It is an innovative method for treatment of cancers which have spread to the peritoneum (a continuous membrane that lines the abdominal cavity and covers the abdominal organs) or originated in the peritoneum. PIPAC can either be used as a standalone palliative chemotherapy, repeated every 2 months till disease progression; or if the disease responds, the patient is assessed after 3 cycles for the feasibility of HIPEC surgery.
Any patient who has peritoneal metastases from any site like ovary, colon, stomach, pancreas, liver, gall bladder, endometrium, breast, or who are unfit for HIPEC (Hyperthermic Intra Peritoneal Chemotherapy) PIPAC is effective. It is an evolving standard of care for the patients who have already received multiple lines of chemotherapy.
The procedure is carried out under general anaesthesia. An average PIPAC procedure will last around 2 hours. The patient can have normal food after 6 hours and if he/she is comfortable, he/she can go home the next day. The dose of chemotherapy required in PIPAC is just 10% of the standard dose; there are no side effects of chemotherapy like hair loss, renal or haematological disturbances. The side effects seen in this procedure include occasional mild fever, malaise and occasional wound infection.