Quality of Life with Vulvar Carcinoma Treated with Palliative Electrochemotherapy: The ELECHTRA (ELEctroCHemoTherapy vulvaR cAncer) Study

Perrone, Anna Myriam; Ferioli, Martina; Argnani, Lisa; Terlizzi, Francesca de; Pirovano, Cecilia; Covarelli, Piero; Dondi, Giulia; Tesei, Marco; Crescenzo, Eugenia De; Ravegnini, Gloria; Galuppi, Andrea; Morganti, Alessio Giuseppe; Iaco, Pierandrea De

doi:10.3390/cancers13071622

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…Based on the available data on 110 patients, the overall response rate (ORR) ranges between 60% and 83% in vulvar SCC ( Table 1 ). However, data on QoL were not reported in these studies, while the analyses of this endpoint from the ELECHTRA study have been recently published [ 40 ]. Moreover, we treated recurrent and metastatic vaginal tumors with promising results (ORR: 67%) [ 41 ] and we tried to avoid extended surgery in VC using ECT as neoadjuvant therapy.…”

Section: Principles Of Electrochemotherapy and The New Palliative Care In Vulvar Cancermentioning

confidence: 99%

Electrochemotherapy in Vulvar Cancer and Cisplatin Combined with Electroporation. Systematic Review and In Vitro Studies

Perrone

Ravegnini

Miglietta

et al. 2021

Cancers

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Electrochemotherapy (ECT) is an emerging treatment for solid tumors and an attractive research field due to its clinical results. This therapy represents an alternative local treatment to the standard ones and is based on the tumor-directed delivery of non-ablative electrical pulses to maximize the action of specific cytotoxic drugs such as cisplatin (CSP) and bleomycin (BLM) and to promote cancer cell death. Nowadays, ECT is mainly recommended as palliative treatment. However, it can be applied to a wide range of superficial cancers, having an impact in preventing or delaying tumor progression and therefore in improving quality of life. In addition, during the natural history of the tumor, early ECT may improve patient outcomes. Our group has extensive clinical and research experience on ECT in vulvar tumors in the palliative setting, with 70% overall response rate. So far, in most studies, ECT was based on BLM. However, the potential of CSP in this setting seems interesting due to some theoretical advantages. The purpose of this report is to: (i) compare the efficacy of CSP and BLM-based ECT through a systematic literature review; (ii) report the results of our studies on CSP-resistant squamous cell tumors cell lines and the possibility to overcome chemoresistance using ECT; (iii) discuss the future ECT role in gynecological tumors and in particular in vulvar carcinoma.

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Section: Principles Of Electrochemotherapy and The New Palliative Care In Vulvar Cancermentioning

confidence: 99%

Electrochemotherapy in Vulvar Cancer and Cisplatin Combined with Electroporation. Systematic Review and In Vitro Studies

Perrone

Ravegnini

Miglietta

et al. 2021

Cancers

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“…Several pilot studies on intraoperative ECT on liver metastases 16 , 28 , 29 , 30 , hepatocellular carcinoma 31 , 32 , perihilar cholangiocarcinoma 33 , 34 , vulvar cancer 35 , 36 , 37 , and renal cancer 38 are available in the literature.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous electrochemotherapy in primary and secondary liver malignancies – local tumor control and impact on overall survival

Spallek¹,

Bischoff²,

Zhou³

et al. 2022

Radiology and Oncology

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Background Local nonsurgical tumor ablation currently represents a further option for the treatment of patients with liver tumors or metastases. Electrochemotherapy (ECT) is a welcome addition to the portfolio of local therapies. A retrospective analysis of patients with liver tumors or metastases treated with ECT is reported. Attention is given to the safety and efficacy of the treatment over time. Patients and methods Eighteen consecutive patients were recruited with measurable liver tumors of different histopatologic origins, mainly colorectal cancer, breast cancer, and hepatocellular cancer. They were treated with percutaneous ECT following the standard operating procedures (SOP) for ECT under general anaesthesia and muscle relaxation. Treatment planning was performed based on MRI preoperative images. The follow-up assessment included contrast-enhanced MR within at least 1–3 months after treatment and then after 5, 7, 9, 12, and 18 months until progression of the disease or death. Results Only mild or moderate side effects were observed after ECT. The objective response rate was 85.7% (complete response 61.9%, partial 23.8%), the mean progression-free survival (PFS) was 9.0 ± 8.2 months, and the overall survival (OS) was 11.3 ± 8.6 months. ECT performed best (PFS and OS) in lesions within 3 and 6 cm diameters (p = 0.0242, p = 0.0297) . The effectiveness of ECT was independent of the localization of the lesions: distant, close or adjacent to vital structures. Progression-free survival and overall survival were independent of the primary histology considered. Conclusions Electrochemotherapy provides an effective valuable option for the treatment of unresectable liver metastases not amenable to other ablative techniques.

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“…This inconvenience is more critical in younger patients and in patients with recurrent diseases. 33 , 34 An alternative to 2 separate stomas is double-barreled wet colostomy (DBWC). This is a lateral loop colostomy that contains both urinary and intestinal diversions in the same segment and drains through a single stoma.…”

Section: Discussionmentioning

confidence: 99%

Electrochemotherapy as an Alternative Treatment Option to Pelvic Exenteration for Recurrent Vulvar Cancer of the Perineum Region

Vivod

Kovačević

Čemažar

et al. 2022

Technol Cancer Res Treat

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Objective: Pelvic exenteration in women with recurrent vulvar carcinoma is associated with high morbidity and mortality and substantial treatment costs. Because pelvic exenteration severely affects the quality of life and can lead to significant complications, other treatment modalities, such as electrochemotherapy, have been proposed. The aim of this study was to evaluate the feasibility and suitability of electrochemotherapy in the treatment of recurrent vulvar cancer. We aimed to analyze the treatment options, treatment outcomes, and complications in patients with recurrent vulvar cancer of the perineum. Methods: A retrospective analysis of patients who had undergone pelvic exenteration for vulvar cancer at the Institute of Oncology Ljubljana over a 16-year period was performed. As an experimental, less mutilating treatment, electrochemotherapy was performed on one patient with recurrent vulvar cancer involving the perineum. Comparative data analysis was performed between the group with pelvic exenteration and the patient with electrochemotherapy, comparing hospital stay, disease recurrence after treatment, survival after treatment in months, and quality of life after treatment. Results: We observed recurrence of disease in 2 patients with initial FIGO stage IIIC disease 3 months and 32 months after pelvic exenteration, and they died of the disease 15 and 38 months after pelvic exenteration. Two patients with FIGO stage IB were alive at 74 and 88 months after pelvic exenteration. One patient with initial FIGO stage IIIC was alive 12 months after treatment with electrochemotherapy with no visible signs of disease progression in the vulvar region, and the lesions had a complete response. The patient treated with electrochemotherapy was hospitalized for 4 days compared with the patients with pelvic exenteration, in whom the average hospital stay was 19.75 (± 1.68) days. Conclusion: Our experience has shown that electrochemotherapy might be a less radical alternative to pelvic exenteration, especially for patients with initially higher FIGO stages.

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Quality of Life with Vulvar Carcinoma Treated with Palliative Electrochemotherapy: The ELECHTRA (ELEctroCHemoTherapy vulvaR cAncer) Study

Cited by 12 publications

References 29 publications

Electrochemotherapy in Vulvar Cancer and Cisplatin Combined with Electroporation. Systematic Review and In Vitro Studies

Electrochemotherapy in Vulvar Cancer and Cisplatin Combined with Electroporation. Systematic Review and In Vitro Studies

Percutaneous electrochemotherapy in primary and secondary liver malignancies – local tumor control and impact on overall survival

Electrochemotherapy as an Alternative Treatment Option to Pelvic Exenteration for Recurrent Vulvar Cancer of the Perineum Region

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