Comparative Evaluation of Nozzle Designs for Enhanced Oxaliplatin Delivery in Pressurized IntraPeritoneal Aerosol Chemotherapy: An In Vivo Study of a Porcine Model.

Background: Various nozzle designs are used in pressurized intraperitoneal aerosol chemotherapy (PIPAC), but comparative in vivo data on their pharmacologic effects are limited.

Methods: Three groups of four pigs each received PIPAC with oxaliplatin (92 mg) using nebulizers with different designs: group 1 (full-spray-cone single directional), group 2 (hollow-spray-cone single directional), and group 3 (full-spray-cone multidirectional). Oxaliplatin concentrations (µg/g) were measured in blood, peritoneal tissue, and intra-abdominal fluid using inductively coupled plasma mass spectrometry.

Results: No significant differences in mean oxaliplatin concentrations in peritoneal tissue were observed: group 1 (12.37 ± 10.81 µg/g), group 2 (5.83 ± 6.18 µg/g), group 3 (9.46 ± 6.10 µg/g) ( p = 0.1002). However, group 3 had a significantly higher mean total oxaliplatin concentration in visceral peritoneal tissue (3.97 ± 0.63 µg/g) than group 1 (2.6 ± 0.56 µg/g) or group 2 (2.15 ± 0.37 µg/g ( p = 0.028). The mean total tissue uptake was also higher in group 3 (41.98 mg) than in group 1 (28.14 mg) or group 2 (36.65 mg) (p = 0.05). Pairwise comparisons showed no significant differences (group 1 vs group 2 [p = 0.1000], group 2 vs group 3 [p = 0.700]). No significant differences in blood absorption were noted (p = 0.106).

Conclusion: The full-spray-cone multidirectional nebulizer design in group 3 resulted in significantly higher oxaliplatin concentrations in the small bowel peritoneum with greater total oxaliplatin tissue uptake than with the two other designs.