Claussen Carla Sophie, Moir Graeme, Bechara Falk G, Orlando Antonio, Matteucci Paolo, Mowatt David, Clover Anthony James P, Mascherini Matteo, Gehl Julie, Muir Tobian, Sersa Gregor, Groselj Ales, Odili Joy, Giorgione Roberto, Campana Luca Giovanni, Bertino Giulia, Curatolo Pietro, Banerjee Shramana, Kis Erika, Quaglino Pietro, Pritchard-Jones Rowan, De Terlizzi Francesca, Grischke Eva-Maria, Kunte Christian
Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany.
The Royal London Hospital & QMUL, Barts Health NHS Trust, Department of Cutaneous Medicine & Surgery, London, United Kingdom.
J Dtsch Dermatol Ges. 2022 Apr;20(4):470-481. doi: 10.1111/ddg.14699. Epub 2022 Apr 5.
Electrochemotherapy (ECT) is an effective local treatment for cutaneous tumors. The aim of this study was to compare the effectiveness of ECT in ulcerated vs. non-ulcerated tumors and investigate the effect on tumor-associated symptoms.
Twenty cancer centers in the International Network for Sharing Practices on Electrochemotherapy (InspECT) prospectively collected data. ECT was performed following ESOPE protocol. Response was evaluated by lesion size development. Pain, symptoms, performance status (ECOG-Index) and health status (EQ-5D questionnaire) were evaluated.
716 patients with ulcerated (n = 302) and non-ulcerated (n = 414) cutaneous tumors and metastases were included (minimum follow-up of 45 days). Non-ulcerated lesions responded to ECT better than ulcerated lesions (complete response 65 % vs. 51 %, p = 0.0061). Only 38 % (115/302) with ulcerated lesions before ECT presented with ulcerated lesions at final follow-up. Patients with ulcerated lesions reported higher pain and more severe symptoms compared to non-ulcerated lesions, which significantly and continuously improved following ECT. In non-ulcerated lesions however, pain spiked during the treatment. No serious adverse events were reported.
ECT is a safe and effective local treatment for cutaneous tumors. While ECT improves symptoms especially in patients with ulcerated lesions, data suggest the implementation of a perioperative pain management in non-ulcerated lesions during ECT.
电化学疗法（ECT）是一种治疗皮肤肿瘤的有效局部治疗方法。本研究旨在比较ECT在溃疡性肿瘤与非溃疡性肿瘤中的疗效，并研究其对肿瘤相关症状的影响。
国际电化学疗法实践分享网络（InspECT）中的20个癌症中心前瞻性收集数据。ECT按照ESOPE方案进行。通过病变大小变化评估反应。评估疼痛、症状、体能状态（ECOG指数）和健康状况（EQ-5D问卷）。
纳入716例患有溃疡性（n = 302）和非溃疡性（n = 414）皮肤肿瘤及转移瘤的患者（最短随访45天）。非溃疡性病变对ECT的反应优于溃疡性病变（完全缓解率分别为65%和51%，p = 0.0061）。ECT前有溃疡性病变的患者中，仅38%（115/302）在最终随访时仍有溃疡性病变。与非溃疡性病变患者相比，溃疡性病变患者报告的疼痛更严重，症状更明显，ECT后这些症状显著且持续改善。然而，在非溃疡性病变中，治疗期间疼痛加剧。未报告严重不良事件。
ECT是一种安全有效的皮肤肿瘤局部治疗方法。虽然ECT尤其能改善溃疡性病变患者的症状，但数据表明在ECT期间应对非溃疡性病变实施围手术期疼痛管理。
