Department of Gynecological Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia; Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
Acta Oncol. 2024 May 21;63:351-357. doi: 10.2340/1651-226X.2024.33241.
Electrochemotherapy (ECT) is a combined treatment method based on electroporation and simultaneous chemotherapy. In cases where radiotherapy has previously been used, surgery is often the only treatment option for vulvar cancer recurrence with potential resection of clitoris, vagina, urethra or anal sphincter. The unique advantage of ECT is its selectivity for cancer cells while sparing the surrounding healthy tissue. The aim of the study was to compare the ECT treatment of vulvar cancer recurrence for non-palliative purposes with surgical treatment.
Eleven patients with single vulvar cancer recurrence were treated with ECT and followed up for 12 months. As a control group, 15 patients with single vulvar cancer recurrence were treated with wide local excision. The following data were collected, analyzed and compared: Age, body mass index, comorbidities, histological type, location and size of vulvar cancer recurrence, treatment history, details of procedures and hospital stay.
The probability curves for local tumor control did not differ between the ECT group and the surgical group (p = 0.694). The mean hospital stay and the mean duration of procedure were statistically significantly shorter in the ECT group (p < 0.001). There were no statistically significant differences between the ECT and surgical groups in terms of mean body mass index, associated diseases, previous treatments, presence of lichen sclerosus, p16 status, gradus, anatomical site of the tumor, and type of anesthesia.
In this case-control study, treatment of vulvar cancer recurrence with ECT for non-palliative purposes was comparable to surgical treatment in terms of effectiveness. The results need to be confirmed in larger randomized trials.
电化疗（ECT）是一种基于电穿孔和同时化疗的联合治疗方法。对于先前接受过放疗的病例，外阴癌复发通常只能选择手术治疗，且有潜在的切除阴蒂、阴道、尿道或肛门括约肌的风险。ECT 的独特优势在于其对癌细胞的选择性，同时又能保护周围的健康组织。本研究旨在比较 ECT 治疗非姑息性外阴癌复发与手术治疗的效果。
对 11 例单发性外阴癌复发患者进行 ECT 治疗，并进行了 12 个月的随访。作为对照组，15 例单发性外阴癌复发患者接受了广泛局部切除术。收集、分析和比较了以下数据：年龄、体重指数、合并症、组织学类型、外阴癌复发的位置和大小、治疗史、手术细节和住院时间。
ECT 组和手术组的局部肿瘤控制概率曲线无差异（p = 0.694）。ECT 组的平均住院时间和手术时间均明显短于手术组（p < 0.001）。ECT 组和手术组在平均体重指数、合并症、既往治疗、是否存在硬化性苔藓、p16 状态、分级、肿瘤解剖部位和麻醉类型方面无统计学差异。
在这项病例对照研究中，非姑息性外阴癌复发的 ECT 治疗与手术治疗在疗效方面相当。需要更大规模的随机试验来验证这些结果。
