Pressurized intra-peritoneal aerosol chemotherapy (PIPAC): increased intraperitoneal pressure does not affect distribution patterns but leads to deeper penetration depth of doxorubicin in a sheep model

Abstract Background Pressurized Intra-Peritoneal Aerosol Chemotherapy (PIPAC) is an innovative treatment against peritoneal carcinomatosis. Doxorubicin a common intra-venous chemotherapy used for carcinomatosis and PIPAC. This study evaluated the impact of increased PIPAC intraperitoneal pressure on distribution cell penetration doxorubicin in sheep model. Methods was aerosolized using into cavity 6 ewes (pre-alpes breed): N = 3 with 12 mmHg (“group 12”) 20 20”). Samples from peritoneum ( 6), ovarian 1), omentum (N 1) caecum were collected each ewe. The number positive cells determined ratio between doxorubicine fluorescence-positive nuclei (DOXO+) over total DAPI (DAPI+). Penetration depth (?m) defined as distance luminal surface location deepest DOXO+ that stained DAPI. nuclei. Results identified 87% samples. All omental samples, directly localized front nebulizer head, had 100% whereas very few caecum. Distribution patterns not different two groups but ovary samples significantly deeper group 20. Conclusions showed applying higher intra-peritoneal during leads to does affect patterns.