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Br J Dermatol. 2017 Jun;176(6):1475-1485. doi: 10.1111/bjd.15340. Epub 2017 Apr 26.

Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT.

Author information

1
Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
2
Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark.
3
Department of Plastic Surgery, Copenhagen University Hospital Herlev, Denmark.
4
Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Rome 'La Sapienza', Rome, Italy.
5
Department of Reconstructive Plastic Surgery, James Cook University Hospital, Middlesbrough, U.K.
6
Department of Otolaryngology Head & Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
7
Department of Plastic Surgery, St George's Hospital, London, U.K.
8
Department of Dermatology, Klinikum Wels-Grieskirchen, Wels, Austria.
9
Department of Plastic Surgery, Whiston Hospital, Prescot, Merseyside, U.K.
10
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
11
Department of Plastic Surgery.
12
Department of Clinical Oncology, Christie Hospital, NHS Foundation Trust, Manchester, U.K.
13
Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, U.K.
14
Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.
15
Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
16
Department of Medical Sciences, Dermatologic Clinic, University of Torino, Torino, Italy.
17
Scientific and Medical Department, IGEA S.p.A., Carpi, Italy.

Abstract

BACKGROUND:

(ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour.

OBJECTIVES:

To investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome.

METHODS:

Thirteen cancer centres in the International Network for Sharing Practices on Electrochemotherapy consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia.

RESULTS:

In total, 151 patients with metastatic melanoma were identified from the database, 114 of whom had follow-up data of 60 days or more. Eighty-four of these patients (74%) experienced an overall response (OR = complete response + partial response). Overall, 394 lesions were treated, of which 306 (78%) showed OR, with 229 showing complete response (58%). In multivariate analysis, factors positively associated with overall response were coverage of deep margins, absence of visceral metastases, presence of lymphoedema and treatment of nonirradiated areas. Factors significantly associated with complete response to ECT treatment were coverage of deep margins, previous irradiation of the treated area and tumour size (< 3 cm). One-year overall survival in this cohort of patients was 67% (95% confidence interval 57-77%), while melanoma-specific survival was 74% (95% confidence interval 64-84%). No serious adverse events were reported, and the treatment was in general very well tolerated.

CONCLUSIONS:

ECT is a highly effective local treatment for melanoma metastases in the skin, with no severe adverse effects noted in this study. In the presence of certain clinical factors, ECT may be considered for local tumour control as an alternative to established local treatments, or as an adjunct to systemic treatments.

PMID:
28118487
DOI:
10.1111/bjd.15340
[Indexed for MEDLINE]

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