Plastic and Reconstruction Surgery Department, Royal Devon and Exeter Hospital, Barack Road, Exeter, EX2 5DW, UK.
Plastic and Reconstruction Surgery Department, Royal Devon and Exeter Hospital, Barack Road, Exeter, EX2 5DW, UK.
Int J Surg. 2018 Apr;52:110-119. doi: 10.1016/j.ijsu.2018.02.040. Epub 2018 Feb 21.
Metastatic spread of malignant tumours to skin is a well described phenomenon with incidence of approximately 0.7-9% of all metastases depending on histological type of primary cancer. Electrochemotherapy (ECT) is an efficient local tumour ablation modality that has proven clinical efficacy in the treatment of various types of tumours metastasis to skin. Aims of this study are to evaluate the activity, toxicity, and feasibility of treating patients with electrochemotherapy (ECT); their clinical outcomes and patient report outcome measures. This was a cohort study of 48 patients. In this study a good or excellent response to treatment was observed in 74% of patients on the basis of the clinical photographs. Five patients had partial responses (14%) and three patients had no response (8.5%). One patient died during the study period (2.8%). 87% of patients said they would have ECT again if clinically indicated. Spearman's' rank correlation of clinical efficacy for anatomical location was found to be positive with poorer outcomes in head and neck compared to trunk and limbs. Complications were found in 16patients, of which all were either grade 1 or 2 Clavien classification. The complications were predominantly in patients treated with ECT for tumours the head and neck area. Initial assessment of applicable patient report outcome measures for our patient cohort demonstrate that there are no validated tools exist for ECT. Further work is required here.
恶性肿瘤转移至皮肤是一种常见现象,根据原发癌的组织学类型,约有 0.7-9%的转移病例出现皮肤转移。电化学疗法(ECT)是一种有效的局部肿瘤消融方法,已被证明在治疗各种类型的皮肤转移瘤方面具有临床疗效。本研究旨在评估电化学疗法(ECT)治疗患者的活性、毒性和可行性;评估其临床结局和患者报告的结局测量指标。这是一项 48 例患者的队列研究。在这项研究中,根据临床照片观察,74%的患者治疗效果良好或优异。5 例患者有部分缓解(14%),3 例患者无反应(8.5%)。1 例患者在研究期间死亡(2.8%)。87%的患者表示如果临床需要,他们会再次接受 ECT。临床疗效与解剖部位的斯皮尔曼等级相关分析显示,头颈部的预后比躯干和四肢差。在 16 例患者中发现了并发症,其中所有并发症均为 1 级或 2 级 Clavien 分级。并发症主要发生在头颈部区域接受 ECT 治疗的患者中。对我们患者队列中适用的患者报告结局测量指标的初步评估表明,目前不存在针对 ECT 的有效验证工具。在此需要进一步研究。