Pc — Intra

1. Definition and Basic Concept Intraperitoneal chemotherapy (Intra-PC) is a locoregional cancer treatment method where chemotherapeutic drugs are delivered directly into the peritoneal cavity —the space within the abdomen that encloses organs like the stomach, liver, intestines, and ovaries.

For the right patient—good performance status, limited extraperitoneal disease, and a tumor biologically responsive to chemotherapy—Intra-PC can convert a uniformly fatal condition (peritoneal carcinomatosis) into a chronic or potentially curable disease. Ongoing innovations like PIPAC and targeted intraperitoneal agents promise to reduce invasiveness and broaden applicability.

| Category | Specific Complications | |----------|------------------------| | | Anastomotic leak, intra-abdominal abscess, bleeding, prolonged ileus, reoperation (10–20%). | | Chemo-related (local) | Chemical peritonitis, sclerosing encapsulating peritonitis (rare but severe bowel obstruction), delayed wound healing. | | Chemo-related (systemic) | Bone marrow suppression, renal toxicity (cisplatin requires sodium thiosulfate protection), neurotoxicity (paclitaxel), ototoxicity. | | HIPEC-specific | Hyperthermia-induced coagulopathy, electrolyte disturbances, hypotension, respiratory compromise (from increased intra-abdominal pressure). | | Catheter/Port-related | Infection, blockage, drug extravasation. |

Intra-PC is not a replacement for systemic chemotherapy but an adjunct or alternative for a specific subset of patients with cancer confined to the abdominal cavity. Its success hinges on multidisciplinary selection, high-volume center care, and meticulous postoperative management.