Electrochemotherapy (ECT) for the treatment of superficial tumor metastases

Abstract

20025 Background: ECT is an effective local treatment for palliation on inoperable superficial neoplastic localizations which combines chemotherapy and electric pulses that permeabilize the cell membrane in a transient and reversible manner, allowing low-perrneant drugs to enter the cell, thus magnifying their cytotoxicity. Recent1y, a new device (Clinoporetor, IGEA S.r.l., Italy) has been developed to supply electric pulses with appropriate parameters permitting the clinical use of ECT. Methods: Until now, we treated 15 pts (median age 57 yrs, range 39–83; median ECOG I, range 1–2; disease/sites: 6 breast with nodular or infiltrating lesions in thoracic or abdominal wall; 5 melanoma, 1 with a wide infiltration of posterior thoracic wall, 4 in transit metastases; 2 head-neck cancer with a wide neck-scalp infiltration; 1 Lymphoma with two cutaneous localizations on the right leg; 1 gastric with 2 cutaneous- subc. localizations on abdominal and right arm). The areas treated ranged from 1 cm to 30 cm on diameter. 5 pts requested a prior surgery debulking and 3 pts received ECT in pre-irradiated area. Intravenous infusion of Bleomycin (15 mg/m2) were used; electric pulses were than applied to the tumor areas by needle electrodes in a time window of about 20 minutes. In total 20 procedures were performed, 6 in local anaesthesia, and 14 in general anaesthesia; 4 pts requested a second procedure because of relapse or new lesions appearing. Results: Treatment was safe and well tolerated, particularly when general anaesthesia was used. After 1 week from the treatment, 100% of the lesions showed an initial regression with a progressive necrotic and fibro-sclerotic evolution (PR 40%, CR 60%). About 50% of lesions remained in remission for a long period (median 8 months, range 3–12); in the other cases a slow relapse or peripheral new lesions occured. Concomitant systemic treatment, surgical debulking, and no rapid progression of disease outside the areas treated, were associated with a better local control. Conclusions: Our preliminary data confirm that ECT is a promising and safe treatment for the control of superficial lesions from different malignancies. No significant financial relationships to disclose.