S.A. Klimin¹˒², S.V. Gamayunov¹˒²˒⁴, E.A. Ashimov¹˒², Ya.I. Kolesnik¹˒², M.I. Makarova¹, R.S. Kokorin¹˒², E.A. Kolesnikova¹, Yu.A. Evseeva¹, S.V. Smetanina¹, V.Yu. Elagina³, A.V. Chameev¹, V.V. Slugarev¹, I.S. Shumskaya¹˒², V.E. Zagainov¹˒², N.M. Kiselev¹˒²
¹Nizhny Novgorod Regional Clinical Oncology Dispensary, Nizhny Novgorod
²Privolzhsky Research Medical University, Nizhny Novgorod
³City Clinical Hospital No. 13, Nizhny Novgorod
⁴A.F. Tsyb Medical Radiological Research Center – Branch of the National Medical Research Center of Radiology, Obninsk
Klimin S.A. — oncologist, Assistant Lecturer of the Department of Oncology, Radiation Therapy and Radiology
11/1 Delovaya St., 603163 Nizhny Novgorod, Russian Federation, tel.: +7-987-540-32-80, е-mail: kliminsergey7@yandex.ru, ORCID ID: 0009-0009-7832-7728
Abstract. The search for new mechanisms to overcome chemoresistance in gastric cancer with peritoneal dissemination is one of the key areas in the management of this patient population. Progress in this field is closely associated with the pathogenesis of peritoneal metastasis. Given the modest improvement in overall and progression-free survival achieved with standard chemotherapy regimens over the past 20 years, local treatment techniques, especially combined with systemic therapy, have significant potential to improve clinical outcomes. One of the latest local approaches is pressurized intraperitoneal aerosol chemotherapy. However, a number of controversial issues remain, including the selection and dosing of intraperitoneal agents, treatment frequency, objective assessment of therapeutic efficacy, and standardization of both the technique and the equipment used.
This review aims to present the current therapeutic options for disseminated gastric cancer and to identify new targets for study, methods for patient selection for various local treatment modalities, and approaches to the management of peritoneal dissemination.
Key words: gastric cancer; peritoneal dissemination; intraperitoneal chemotherapy; aerosol chemotherapy; pressurized intraperitoneal aerosol chemotherapy (PIPAC)