Spugnini E P, Citro G, Porrello A
S.A.F.U. Department, Regina Elena Cancer Institute, Center for Experimental Research, Rome, Italy.
J Exp Clin Cancer Res. 2005 Jun;24(2):245-54.
Electrochemotherapy associates the local delivery of anticancer drugs with the administration of permeabilizing electric pulses that support the antiblastic action. The basic instrumentation for this therapy is constituted by a pulse generator and various specific electrodes. While many efforts have been profuse by researchers in this field to obtain the standardization of the pulse generating equipment over the past 15 years, the delivery apparatus still needs refinements in order to reach most of the body districts, to control the homogeneity and stability of the electric fields and to further reduce morbidity. With the aim to develop innovative electrodes able to satisfy, at least partially, these requirements, extensive studies on pet patients with spontaneous neoplasms have been conducted, leading to the manufacturing of several different prototypes. In this paper we discuss the rationale of 11 different electrodes, briefly summarize the results obtained and their experimental validation, also presenting five paradigmatic clinical cases. In particular, it is shown that the caliper electrodes are more suited for the treatment of cutaneous and subcutaneous lesions, while the needle arrays are more efficacious in intraoperative settings. Furthermore, relevant peculiarities of unipolar electrodes are examined with a particular focus on the irregular current paths that they produce and on the potentialities of this feature. Remarkably, the decrease of the steric encumbrance turned out to be a stronger factor in electrode design than the containment of the total number of electric fields covered in serial ECT sessions. In the conclusions, perspectives and new challenges of electrode design for electrochemotherapy are illustrated.
电化学疗法将抗癌药物的局部递送与渗透性电脉冲的施加相结合，以支持抗增殖作用。这种疗法的基本仪器由脉冲发生器和各种特定电极组成。在过去15年里，该领域的研究人员为实现脉冲发生设备的标准化付出了诸多努力，但递送装置仍需改进，以便能够触及身体的大部分区域，控制电场的均匀性和稳定性，并进一步降低发病率。为了开发至少能部分满足这些要求的创新电极，我们对患有自发性肿瘤的宠物患者进行了广泛研究，制造出了几种不同的原型。在本文中，我们讨论了11种不同电极的原理，简要总结了所取得的结果及其实验验证，并展示了5个典型临床病例。特别指出的是，卡尺电极更适合治疗皮肤和皮下病变，而针阵列在术中环境中更有效。此外，我们还研究了单极电极的相关特性，特别关注它们产生的不规则电流路径以及这一特性的潜力。值得注意的是，在电极设计中，空间占位的减少被证明是比连续电化学疗法（ECT）疗程中覆盖的电场总数的控制更强的因素。在结论部分，阐述了电化学疗法电极设计的前景和新挑战。
