How we do it: Chemo‐electroporation in the head and neck for otherwise untreatable patients

Tijink, Bernard M.; Bree, Remco de; Dongen, Guus A.M.S. van; Leemans, C. René

doi:10.1111/j.1749-4486.2006.01198.x

Cited by 25 publications

(28 citation statements)

References 4 publications

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“…The metastases were divided into smaller or larger than 3 cm to enable comparison with previous studies. The response rate for the cutaneous metastases <3 cm is similar to the ESOPE [5] and other studies [13,23,24], whereas for larger metastases, the OR is considerably lower, which is in agreement with previous observations [13]. In patients with large volume disease, the purpose is not necessarily to eradicate the cutaneous metastases, but to obtain palliative relief in terms of decreased odour, exudate and bleeding.…”

Section: Discussionsupporting

confidence: 89%

Management of cutaneous metastases using electrochemotherapy

et al. 2011

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Background. Cutaneous metastases may cause considerable discomfort as a consequence of ulceration, oozing, bleeding and pain. Electrochemotherapy has proven to be highly effective in the treatment of cutaneous metastases. Electrochemotherapy utilises pulses of electricity to increase the permeability of the cell membrane and thereby augment the effect of chemotherapy. For the drug bleomycin, the effect is enhanced several hundred-fold, enabling once-only treatment. The primary endpoint of this study is to evaluate the efficacy of electrochemotherapy as a palliative treatment. Methods. This phase II study is a collaboration between two centres, one in Denmark and the other in the UK. Patients with cutaneous metastases of any histology were included. Bleomycin was administered intratumourally or intravenously followed by application of electric pulses to the tumour site. Results. Fifty-two patients were included. Complete and partial response rate was 68% and 18%, respectively, for cutaneous metastases <3 cm and 8% and 23%, respectively, for cutaneous metastases >3 cm. Treatment was well-tolerated by patients, including the elderly, and no serious adverse events were observed. Conclusions. ECT is an efficient and safe treatment and clinicians should not hesitate to use it even in the elderly.

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Section: Discussionsupporting

confidence: 89%

Management of cutaneous metastases using electrochemotherapy

et al. 2011

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“…Several studies have investigated the effectiveness of ECT . A study on the efficacy and safety of ECT published in 2006 by Mir et al .…”

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confidence: 99%

Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT

et al. 2017

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Summary Background (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. Objectives To investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome. Methods Thirteen cancer centres in the International Network for Sharing Practices on Electrochemotherapy consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. Results In total, 151 patients with metastatic melanoma were identified from the database, 114 of whom had follow‐up data of 60 days or more. Eighty‐four of these patients (74%) experienced an overall response (OR = complete response + partial response). Overall, 394 lesions were treated, of which 306 (78%) showed OR, with 229 showing complete response (58%). In multivariate analysis, factors positively associated with overall response were coverage of deep margins, absence of visceral metastases, presence of lymphoedema and treatment of nonirradiated areas. Factors significantly associated with complete response to ECT treatment were coverage of deep margins, previous irradiation of the treated area and tumour size (< 3 cm). One‐year overall survival in this cohort of patients was 67% (95% confidence interval 57–77%), while melanoma‐specific survival was 74% (95% confidence interval 64–84%). No serious adverse events were reported, and the treatment was in general very well tolerated. Conclusions ECT is a highly effective local treatment for melanoma metastases in the skin, with no severe adverse effects noted in this study. In the presence of certain clinical factors, ECT may be considered for local tumour control as an alternative to established local treatments, or as an adjunct to systemic treatments.

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“…3 Numerous studies have demonstrated ECT to be a very efficient treatment in various tumor types; in recent years, it has become a treatment of choice for cutaneous and subcutaneous tumor nodules of different histologies. [4][5][6][7][8][9] Two conditions have to be met for ECT to be efficient: 1) a sufficient amount of chemotherapeutic drug has to be present in the target tissue, when the electric pulses are applied; 2) the electric pulses have to reversibly electroporate the entire tumor volume, which means that the electric field established by the pulses should be of a magnitude between the reversible and irreversible electroporation threshold (E rev < E < E irrev ). The optimal ECT protocol should thus destroy all tumor cells, while minimising electrically induced damage to healthy tissue due to irreversible electroporation.…”

Section: Introductionmentioning

confidence: 99%