Treatment efficacy with electrochemotherapy: a multi-institutional prospective observational study on 376 patients with superficial tumors

• Published in: European journal of surgical oncology 2016-12, Vol.42 (12), p.1914-1923
• Main Authors: Campana, L.G., M.D., Ph.D, Testori, A, Curatolo, P, Qaglino, P, Mocellin, S, Framarini, M, Borgognoni, L, Ascierto, P.A, Mozzillo, N, Guida, M, Bucher, S, Rotunno, R, Marenco, F, De Salvo, G.L, De Paoli, A, Rossi, C.R, Bonadies, A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Basal cell carcinoma; Bleomycin - therapeutic use; Breast cancer; Breast Neoplasms - pathology; Carcinoma - secondary; Carcinoma - therapy; Carcinoma, Basal Cell - secondary; Carcinoma, Basal Cell - therapy; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - therapy; Cisplatin - therapeutic use; Cutaneous metastases; Electrochemotherapy; Electrochemotherapy - methods; Female; Hematology, Oncology and Palliative Medicine; Humans; Injections, Intralesional; Kaplan-Meier Estimate; Male; Melanoma; Melanoma - secondary; Melanoma - therapy; Middle Aged; Proportional Hazards Models; Prospective Studies; Sarcoma - secondary; Sarcoma - therapy; Sarcoma, Kaposi - secondary; Sarcoma, Kaposi - therapy; Skin Neoplasms - pathology; Skin Neoplasms - secondary; Skin Neoplasms - therapy; Squamous cell carcinoma; Surgery; Treatment Outcome; Young Adult
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2016.06.399

Abstract Background Cutaneous metastases represent a therapeutic challenge. An increasing body of experience suggests that electrochemotherapy (ECT) provides effective tumor control, although its evidence basis should be strengthened. Methods This prospective, multicenter, observational study enrolled patients with superficial metastases, who underwent ECT at 10 centers between 2008 and 2013. Outcomes included adherence to European Standard Operating Procedures of ECT (ESOPE), tumor response, local progression-free survival (LPFS), toxicity and patient-reported outcomes (PROs, EORTC QLQ-C30 plus an 8-item questionnaire). Results We enrolled 376 eligible patients. Tumor histotype distribution was as follows: melanoma, 56%; squamous cell carcinoma, 11%; Kaposi sarcoma, 11%; breast carcinoma, 8%; basal cell carcinoma, 6%; soft tissue sarcomas, 3%; others, 5%. We registered 1,304 target tumors (median size 1 cm). Treatment adhered to ESOPE in 88% of patients as to the route of drug administration, and in 70% as to electrode application. The procedure was mainly performed under sedation (64.6%) and by using intravenous chemotherapy (93.4%). Tumor response rate at 60 days was 88% (complete, 50%). Small tumor size predicted complete response achievement (OR 2.24, p =0.003), higher LPFS (HR 0.68, p =0.004) and improved PROs (Global Health Status, p