Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark.
Br J Dermatol. 2017 Jun;176(6):1475-1485. doi: 10.1111/bjd.15340. Epub 2017 Apr 26.
(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.
To investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome.
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.
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.
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.
（ECT）是一种有效的皮肤转移瘤局部治疗方法。治疗包括给予化疗药物，然后向肿瘤输送电脉冲。
研究 ECT 治疗皮肤转移性黑色素瘤的有效性，并确定影响（有利或不利）结果的因素。
国际电化学治疗实践共享网络的 13 个癌症中心连续前瞻性地将数据上传到一个共同数据库。ECT 由博来霉素的肿瘤内或静脉内注射组成，然后在局部或全身麻醉下应用电脉冲。
从数据库中确定了 151 例转移性黑色素瘤患者，其中 114 例有 60 天或以上的随访数据。其中 84 例（74%）患者出现总体反应（OR=完全缓解+部分缓解）。总共治疗了 394 个病变，其中 306 个（78%）病变出现 OR，其中 229 个病变出现完全缓解（58%）。多因素分析显示，与总体反应相关的因素包括深切缘覆盖、无内脏转移、淋巴水肿存在和非照射区域治疗。与 ECT 治疗完全缓解显著相关的因素包括深切缘覆盖、治疗区域的先前照射和肿瘤大小（<3cm）。该患者队列的 1 年总生存率为 67%（95%置信区间 57-77%），而黑色素瘤特异性生存率为 74%（95%置信区间 64-84%）。本研究未报告严重不良事件，且治疗总体上耐受性良好。
ECT 是一种治疗皮肤黑色素瘤转移的高效局部治疗方法，本研究未观察到严重不良事件。在存在某些临床因素的情况下，ECT 可考虑作为替代现有局部治疗或作为全身治疗辅助手段，用于局部肿瘤控制。
