Bocchi Maria Beatrice, Meschini Cesare, Pietramala Silvia, Perna Andrea, Oliva Maria Serena, Matrangolo Maria Rosaria, Ziranu Antonio, Maccauro Giulio, Vitiello Raffaele
Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Department of Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Clin Med. 2023 Sep 23;12(19):6150. doi: 10.3390/jcm12196150.
Cancers are one of the most frequent causes of death and disability in humans. Skeletal involvement has a major impact on the quality of life and prognosis of cancer patients. Electrochemotherapy is a palliative and minimally invasive oncologic treatment that was first used to treat subcutaneous nodules for malignant tumors. The aim of our review is to evaluate the results of electrochemotherapy in the treatment of bone metastases.
A systematic review of the literature indexed in the PubMed MEDLINE and Cochrane Library databases using the search key words "electrochemotherapy" AND ("metastasis" OR "metastases") was performed. The Preferred Reporting Items for Systematic Reviews and MetaAnalyses was followed. Inclusion criteria were proven involvement of the appendicular skeleton in metastatic carcinoma or melanoma, through at least one percutaneous electrochemotherapy session on the metastatic bone lesion. The exclusion criterion was no skeletal metastatic involvement.
Eight articles were finally included. We reached a population of 246 patients. The mean age and follow up were 60.1 years old and 11.4 months, respectively. The most represented primary tumor was breast cancer (18.9%). A total of 250 bone lesions were treated with electrochemotherapy. According to RECIST criteria, in our population we observed 55.5% stable diseases. The mean pre-electrochemotherapy VAS value was 6.9, which lowered to 2.7 after treatment. Adverse events occurred in 3.4% of patients.
Electrochemotherapy as a minimally invasive and tissue-sparing treatment should be considered for patients with no other alternative to obtain tumor control and improvement in quality of life.
癌症是人类最常见的死亡和致残原因之一。骨骼受累对癌症患者的生活质量和预后有重大影响。电化学疗法是一种姑息性微创肿瘤治疗方法，最初用于治疗恶性肿瘤的皮下结节。我们综述的目的是评估电化学疗法治疗骨转移的效果。
使用关键词“电化学疗法”以及（“转移”或“转移灶”）对PubMed MEDLINE和Cochrane图书馆数据库中索引的文献进行系统综述。遵循系统评价和Meta分析的首选报告项目。纳入标准为经证实转移性癌或黑色素瘤累及四肢骨骼，且对转移性骨病变至少进行过一次经皮电化学疗法治疗。排除标准为无骨骼转移受累。
最终纳入8篇文章。我们纳入了246例患者。平均年龄和随访时间分别为60.1岁和11.4个月。最常见的原发肿瘤是乳腺癌（18.9%）。总共250处骨病变接受了电化学疗法治疗。根据RECIST标准，在我们的研究人群中，观察到55.5%的疾病稳定。电化学疗法前VAS值平均为6.9，治疗后降至2.7。3.4%的患者发生了不良事件。
对于没有其他选择的患者，应考虑将电化学疗法作为一种微创且保留组织的治疗方法，以实现肿瘤控制并改善生活质量。
