Electrochemotherapy: new treatment approach for Hepatocellular Carcinoma: Results of phase I study

Abstract

Background: Incidence of Hepatocellular Carcinoma(HCC) is rising across the world and it is one of the commonest causes of cancer-related deaths in the world but only 20 % of patients are candidates for curative treatment. When radical treatment is not indicated, transarterial chemoembolization (TACE), radiofrequency ablation (RFA), and other methods are being used for disease control [1,2]. The data on effectiveness of electrochemotherapy (ECT) in cutaneous and some other tumors are numerous but there are limited data on feasibility and efficacy of ECT for liver tumor [3–5]. Methods: For the treatment of patients with HCC with ECT, a phase I study was designed and concluded in 10 patients who fulfilled inclusion criteria. The primary goal of study was to assess the feasibility and effectiveness of ECT in HCC. Effectiveness was evaluated by mRECIST criteria using CT and/or MRI as a diagnostic tool. After multidisciplinary meeting included patients into study, a pretreatment plan was made. The treatment was performed during open surgery using electrodes with variable or fixed geometry guided by ultra sound.After their insertion, BLM was injected and the electric pulses was applied after 8 minutes. A CT scan or MRI was done according to the study protocol. Results: Our study shows high rate of complete responds lesions that were treated by mRECIST criteria without higher morbidity or mortality rate. Conclusion: Study proved that ECT is in some patients with HCC safe and effective treatment option.