Abstract
Bone metastases induce pain, risk of fracture, and neural compression, and reduced mobility and quality of life. Electrochemotherapy (ECT) is a minimally invasive local treatment based on a high-voltage electric pulse combined with an anticancer drug. Preclinical and clinical studies have supported the use of ECT in patients with metastatic bone disease, demonstrating that it does not damage the mineral structure of the bone and its regenerative capacity, and that is feasible and efficient for the treatment of bone metastases. Since 2009, 88 patients with bone metastasis have received ECT at the Rizzoli Institute. 2014 saw the start of a registry of patients with bone metastases treated with ECT, whose data are recorded in a shared database. We share the Rizzoli Institute experience of 38 patients treated with ECT for a bone metastasis, excluding patients not included in the registry (before 2014) and those treated with bone fixation. Mean follow-up was 2 months (1–52). Response to treatment using RECIST criteria was 29% objective responses, 59% stable disease, and 16% progressive disease. Using PERCIST, the response was 36% OR, 14% SD, and 50% PD with no significant differences between the two criteria. A significant decrease in pain and better quality of life was observed at FU.
Highlights
Spinal cord compression resulting in neurological deterioration, metabolic imbalances secondary to hypercalcemia, and prolonged movement reduction due to pathological fracture or risk of fracture must be handled
Prostate, breast, kidney, and thyroid cancers are responsible for almost 80% of these skeleton lesions [5,6]
This paper aims to share the Rizzoli Institute experience of 38 patients that received ECT to treat bone metastases whose data were registered in the database
Summary
According to a Global Cancer Observatory (GLOBOCAN) 2020 publication, cancer is one of the leading death causes worldwide and the most significant disease burden globally [1]. Because of survival times prolonging and cancer rates increasing due to demographic changes, accumulative cancer cases are rising [3] This compound number of cancer patients has forced medical care providers to widen treatment options to improve quality of life. Many complications that patients with cancer might experience and compromise their life quality arise from bone metastasis [4]. Symptoms such as pain, spinal cord compression resulting in neurological deterioration, metabolic imbalances secondary to hypercalcemia, and prolonged movement reduction due to pathological fracture or risk of fracture must be handled. But local treatments must sometimes be added to solve or prevent orthopedic complications
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