Safety and Feasibility of Vulvar Cancer Treatment with Electrochemotherapy

Abstract

Electrochemotherapy is a local ablative therapy used for the treatment of various superficial and deep-seated tumors. Electrochemotherapy involves the application of electric pulses locally to tumors to destabilize cell membranes and facilitate the entry of cytotoxic drugs, thereby enhancing their cytotoxicity locally. The aim of our study is to investigate the safety and feasibility of electrochemotherapy in patients with vulvar cancer recurrence used for nonpalliative purposes. Ten patients with single local vulvar cancer recurrence were treated with intravenous bleomycin, followed by a local application of electric pulses (electrochemotherapy) to the tumor. Adverse events were determined using the National Cancer Institute’s Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The feasibility of treating vulvar cancer with electrochemotherapy was determined by an appropriate selection of electrodes based on the size and location of the tumor with safety margins included. Electrochemotherapy was feasible in all patients. No electrochemotherapy-related or other serious adverse events occurred. Our data suggest that electrochemotherapy is a feasible and safe technique for the treatment of vulvar cancer recurrence for nonpalliative purposes. Based on our results, electrochemotherapy might be a viable therapeutic tool for patients who would otherwise undergo surgery involving a mutilation of the external genitalia.

Treatment of vulvar cancer recurrence with electrochemotherapy: a case-control study

“…The advantages of treating vulvar cancer recurrence with ECT compared to surgical treatment were the shorter duration of the procedure and the shorter hospital stay. Based on the safety results of a previous studies of treatment of vulvar cancer with ECT, the patient could be admitted and discharged from the hospital on the same day [16,20]. The shorter duration of ECT is the only need to arrange the electrodes appropriately to deliver the electrical pulses throughout the tumor area with the surgical safety margin [21].…”

“…The surgeon had to compromise on the surgical safety margin or make the decision to perform a pelvic exenteration, which is associated with high morbidity and mortality [26]. In ECT, the entire area of the tumor and the surgical safety margin of one centimeter are covered with an appropriate selection of electrodes [20,21]. This is particularly important in the recurrence of vulvar cancer near the clitoris, vagina, anus, or urethra, where ECT destroys the cancer cells but spares the tissues and organs around the tumor.…”

“…In 2023, our group published for the first time the data of a study in which ECT was used to treat the recurrence of vulvar cancer for non-palliative purposes. ECT has been shown to be a feasible and safe technique for the treatment of vulvar cancer recurrence [20]. The aim of the study was to compare the ECT treatment of vulvar cancer recurrence for non-palliative purposes with surgical treatment.…”

“…From July 2020 to January 2023, 11 patients with vulvar cancer recurrence were treated with ECT. Patients were included in the study according to the inclusion and exclusion criteria [20]. A cohort of 15 patients with vulvar cancer recurrence who were treated with wide local excision from January 2018 to January 2023 was selected as a control group.…”

Intraoperative implantation of 125I seeds improves prognosis in refractory stage IIIB cervical cancer: a case report and literature review

“…One safe and successful treatment option for recurrent vulvar cancer is electrochemical therapy. It can also be used as a part of non-standard treatment for recurrent cervical cancer [ 6 ].…”