Bleomycin-Based Electrochemotherapy: Clinical Outcome from a Single Institution's Experience with 52 Patients
Bleomycin-Based Electrochemotherapy: Clinical Outcome from a Single Institution's Experience with 52 Patients
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DOI：
10.1245/s10434-008-0204-8
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发表时间：
2009-01-01
影响因子：
3.7
通讯作者：
Nitti, Donato
中科院分区：
文献类型：
--
作者：
Campana, Luca G.;Mocellin, Simone;Nitti, Donato
电化学疗法（ECT）已成为浅表转移瘤的补充治疗。52例不同癌症组织类型的连续患者，主要是黑色素瘤和乳腺癌，其疾病不适合常规治疗，接受了基于博来霉素的ECT治疗皮肤和皮下转移。评价了毒性、局部反应、反应持续时间和对生活质量的影响。共治疗了608个肿瘤结节（平均每例患者12个），27%的患者受结节大小> 3 cm的影响。治疗耐受性良好，特别是在全身镇静下。首次应用后1个月，52例患者中有50例（96%）获得客观缓解。22例患者接受了第二次治疗（由于部分缓解或出现新病变）。第一次ECT的部分响应在第二次应用时实现了响应巩固：80%完全响应，20%部分响应。一些患者由于新的病变接受了多达五次治疗，但保持了浅表肿瘤控制。在平均随访9个月（范围，2-21）后，只有2例患者在治疗区域复发。通过未经验证的8项问卷（评估伤口愈合和出血、美观受损、日常活动、社会关系、疼痛、治疗满意度、接受再治疗），大多数患者报告局部疾病相关投诉和日常生活活动获益。在姑息治疗中，ECT被证明是安全的，对所有治疗的肿瘤都有效，并且有助于保持患者的生活质量。这一益处虽然是初步的，但值得在正式验证专用调查表后进一步评估。
Electrochemotherapy (ECT) has emerged as a complementary treatment for superficial metastases. Fifty-two consecutive patients with different cancer histotypes, mainly melanoma and breast cancer, with disease unsuitable for conventional treatments underwent bleomycin-based ECT for cutaneous and subcutaneous metastases. Toxicity, local response, response duration, and the impact on quality of life were evaluated. A total of 608 tumor nodules were treated (mean, 12 per patient), with 27% of patients affected by nodules > 3 cm in size. Treatment was tolerated well, especially under general sedation. An objective response was obtained in 50 (96%) of 52 patients 1 month after the first application. Twenty-two patients underwent a second treatment (because of partial response or the appearance of new lesions). Partial response at first ECT achieved a response consolidation at second application: 80% complete response, 20% partial response. Some patients underwent up to five treatments because of new lesions, but maintained superficial tumor control. After a mean follow-up of 9 (range, 2-21) months, only two patients experienced relapse in the treatment field. Through a nonvalidated eight-item questionnaire (assessing wound healing and bleeding, aesthetic impairment, daily activities, social relations, pain, treatment satisfaction, acceptance of retreatment), most patients reported a benefit in local disease-related complaints and in activity of daily living. In a palliative setting, ECT proved to be safe, effective in all tumors treated, and useful in preserving patients' quality of life. This benefit, although preliminary, deserves further assessment after a formal validation of the dedicated questionnaire.