Predicting patients at risk for pain associated with electrochemotherapy

Quaglino, Pietro; Matthiessen, Louise Wichmann; Curatolo, P.; Muir, Tobian; Bertino, Giulia; Kunte, Christian; Odili, Joy; Rotunno, Roberta; Humphreys, A; Letulé, Valerie; Marenco, Federica; Cuthbert, Carol; Albret, Rikke; Benazzo, Marco; Terlizzi, Francesca de; Gehl, Julie

doi:10.3109/0284186x.2014.992546

Cited by 59 publications

(63 citation statements)

References 24 publications

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“…The results from this paper showed that 39% of the patients had post‐treatment pain managed by oral analgesia alone. This is similar to values previously published . No other severe adverse effects were noted.…”

Section: Discussionsupporting

confidence: 92%

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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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Section: Discussionsupporting

confidence: 92%

“…Pain medication was registered as ‘none’, ‘sometimes’, ‘controlled by nonopioids’, ‘controlled by opioids’, ‘uncontrolled’ or ‘unknown’. Evaluation of pain and pain medication was repeated at the follow‐up visit …”

Section: Methodsmentioning

confidence: 99%

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

et al. 2017

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“…Some patients underwent up to three treatments because of new lesions, but maintained superficial tumor control. After a median follow-up of 12 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) months, only one patient experienced relapse in the treatment field, localized in the same treated site. Mapping of the lesions showed that disease was present in the vulva in 100% of cases.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of patients had no or mild pain after ECT. Patients at risk for post-procedure pain could be identified at the pretreatment visit, and/or at the time of treatment, enabling a pain management strategy for this group [7]. The aim of this preliminary study was to evaluate the safety, local efficacy, acceptability and QoL of ECT with bleomycin in reducing the size of tumors in patients with vulvar carcinoma with locoregional cutaneous recurrence submitted to multiple previous treatments (chemotherapy, radiotherapy and surgery) and unsuitable for standard treatments.…”

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confidence: 99%

Outcomes of Bleomycin-based electrochemotherapy in patients with repeated loco-regional recurrences of vulvar cancer

et al. 2016

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“…In addition, we found that patients with moderate‐to‐severe pain pretreatment were more difficult to adjust in analgesic consumption and did not achieve a pain improvement after treatment. A study by Quaglino et al supports this observation and also emphasizes that previously irradiated and/or large tumors will have an increased risk of posttreatment pain after electrochemotherapy.…”

Section: Discussionmentioning

confidence: 82%

The DAHANCA 32 study: Electrochemotherapy for recurrent mucosal head and neck cancer

et al. 2018

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Background Electrochemotherapy is an established treatment for cutaneous tumors. This study aimed at determining efficacy of electrochemotherapy in recurrent head and neck cancer. Methods Phase II clinical trial in patients with recurrent head and neck carcinomas with no curative treatment options. Electrochemotherapy was performed under general anesthesia. Primary endpoint was tumor response (CT scanning) evaluated at week 8. Secondary endpoints included biopsy results, MRI and fluorodeoxyglucose‐positron emission tomography scanning, safety, toxicity, pain score, and quality‐of‐life questionnaires. Results Of 26 patients treated, 5 (19%) achieved complete response, 10 (39%) partial response, resulting in an objective response of 58%. Two responders remain without recurrence. No serious adverse events occurred during treatment. Four events occurred posttreatment: one bleeding episode, two episodes with mucosal swelling, and one patient died due to disease progression. Conclusion Electrochemotherapy is efficient against local recurrence of head and neck cancer with an overall response rate of 58%.

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Predicting patients at risk for pain associated with electrochemotherapy

Abstract: The majority of patients had no or mild pain after electrochemotherapy. Patients at risk for post-procedure pain could be identified at the pre-treatment visit, and/or at the time of treatment, enabling a pain management strategy for this group.

Cited by 59 publications

References 24 publications

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

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

Outcomes of Bleomycin-based electrochemotherapy in patients with repeated loco-regional recurrences of vulvar cancer

The DAHANCA 32 study: Electrochemotherapy for recurrent mucosal head and neck cancer

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