Ricotti F, Giuliodori K, Cataldi I, Campanati A, Ganzetti G, Ricotti G, Offidani A
Dermatological Clinic, Department of Clinical and Molecular Medicine, Polytechnic Marche University, Ancona, Italy.
Dermatol Ther. 2014 May-Jun;27(3):148-52. doi: 10.1111/dth.12098. Epub 2013 Sep 24.
Treatment of multiple cutaneous and subcutaneous melanoma metastases is still represents a therapeutic challenge for both dermatologists and oncologists. Electrochemotherapy (ECT) is a promising therapeutic procedure, owing to its ability to improve the penetration of cytotoxic drugs into cancer cells by application of current electric pulses. The aim of our study is to evaluate efficacy, tolerability and long-term efficacy of ECT in the treatment of advanced metastatic melanoma. Thirty patients affected by a total of 654 cutaneous and subcutaneous melanoma metastatic nodules were recruited. All patients were treated after they had undergone to a mild general anesthesia. Intravenous Bleomicina solution was administered 8 minutes before the application of electric pulses, generated by a Cliniporator (TM) (the device validated for ECT). The objective response rate of 100% (67.28% complete response and 32.72% partial response) was observed. A total of 214 metastatic lesions from 24 patients received a second ECT session, among them 141 showed a further complete response. Twenty-four months later, the local tumor control rate was 72%. The results of this study seem to demonstrate that ECT is an effective and valid therapeutic tool for the treatment of cutaneous metastases from melanoma. ECT can be considered a first-line palliative treatment since it is able to alleviate pain and reduce the tumor's spontaneous bleeding with a significant improve of patients' quality of life.
多发性皮肤和皮下黑色素瘤转移的治疗对于皮肤科医生和肿瘤学家而言仍然是一项治疗挑战。电化学疗法(ECT)是一种很有前景的治疗方法,因为它能够通过施加电流脉冲提高细胞毒性药物进入癌细胞的渗透率。我们研究的目的是评估ECT治疗晚期转移性黑色素瘤的疗效、耐受性和长期疗效。招募了30例共有654个皮肤和皮下黑色素瘤转移结节的患者。所有患者在接受轻度全身麻醉后进行治疗。在由Cliniporator(TM)(经ECT验证的设备)产生的电脉冲施加前8分钟静脉注射博来霉素溶液。观察到客观缓解率为100%(完全缓解率为67.28%,部分缓解率为32.72%)。来自24例患者的总共214个转移病灶接受了第二次ECT治疗,其中141个显示进一步完全缓解。24个月后,局部肿瘤控制率为72%。本研究结果似乎表明,ECT是治疗黑色素瘤皮肤转移的一种有效治疗工具。ECT可被视为一线姑息治疗,因为它能够减轻疼痛并减少肿瘤的自发性出血,显著改善患者的生活质量。