Electrochemotherapy within the therapy of metastatic malignant melanoma: a potential cohort research by InspECT.
Br J Dermatol. 2017 Jun;176(6):1475-1485
Authors: Kunte C, Letulé V, Gehl J, Dahlstroem Ok, Curatolo P, Rotunno R, Muir T, Occhini A, Bertino G, Powell B, Saxinger W, Lechner G, Liew SH, Pritchard-Jones R, Rutkowski P, Zdzienicki M, Mowatt D, Sykes AJ, Orlando A, Mitsala G, Rossi CR, Campana L, Brizio M, de Terlizzi F, Quaglino P, Odili J, InspECT (the Worldwide Community for Sharing Practices on Electrochemotherapy)
BACKGROUND: (ECT) is an efficient native therapy for cutaneous metastasis. Therapy entails the administration of chemotherapeutic medicine adopted by supply pulses to the tumour.
OBJECTIVES: To analyze the effectiveness of ECT in cutaneous metastases of melanoma and to establish elements that have an effect on (beneficially or adversely) the result.
METHODS: 13 most cancers centres within the Worldwide Community for Sharing Practices on Electrochemotherapy consecutively and prospectively uploaded information to a standard database. ECT consisted of intratumoral or intravenous injection of bleomycin, adopted by utility of electrical pulses below native or basic anaesthesia.
RESULTS: In whole, 151 sufferers with metastatic melanoma had been recognized from the database, 114 of whom had follow-up information of 60 days or extra. Eighty-four of those sufferers (74%) skilled an general response (OR = full response + partial response). General, 394 lesions had been handled, of which 306 (78%) confirmed OR, with 229 displaying full response (58%). In multivariate evaluation, elements positively related to general response had been protection of deep margins, absence of visceral metastases, presence of lymphoedema and therapy of nonirradiated areas. Elements considerably related to full response to ECT therapy had been protection of deep margins, earlier irradiation of the handled space and tumour dimension (< three cm). One-year general survival on this cohort of sufferers was 67% (95% confidence interval 57-77%), whereas melanoma-specific survival was 74% (95% confidence interval 64-84%). No critical opposed occasions had been reported, and the therapy was normally very properly tolerated.
CONCLUSIONS: ECT is a extremely efficient native therapy for melanoma metastases within the pores and skin, with no extreme opposed results famous on this research. Within the presence of sure medical elements, ECT could also be thought-about for native tumour management as an alternative choice to established native remedies, or as an adjunct to systemic remedies.
PMID: 28118487 [PubMed – indexed for MEDLINE]