NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 8 sources, which was discussed by the committee. The evidence included 4 systematic reviews, 3 case series and 1 case report. It is presented in table 2 of the interventional procedures overview. Other relevant literature is in the appendix of the overview.
The specialist advisers and the committee considered the key efficacy outcomes to be: improved quality of life and prolonged survival.
The specialist advisers and the committee considered the key safety outcomes to be: peritoneal sclerosis, bowel damage and inadvertent leakage of chemotherapy agents into the environment.
One patient commentary from a patient who had experience of this procedure was received, which was discussed by the committee.
The committee noted that the intent of the procedure is palliation.
The committee noted that several different chemotherapy drugs have been used in this procedure and that the toxicity profile and efficacy for each of these may be different.
There is a potential risk that chemotherapy could be dispersed into the operating theatre environment. The committee were informed that this risk has been mitigated with robust safety measures.
The committee noted that the procedure is usually used with intravenous chemotherapy.
The committee noted that the technology is evolving to include, for example, using electrostatic charge.
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