Ferioli Martina, Arcelli Alessandra, Cilla Savino, Zamfir Arina A, Tolento Giorgio, Cuicchi Dajana, Buwenge Milly, Galietta Erika, Fionda Bruno, Tagliaferri Luca, Rottoli Matteo, Poggioli Gilberto, Morganti Alessio G
Radiation Oncology, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.
Radiation Oncology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - Bologna University, Bologna, Italy.
Technol Cancer Res Treat. 2025 Jan-Dec;24:15330338251349596. doi: 10.1177/15330338251349596. Epub 2025 Jul 8.
This narrative review explores the potential role of electrochemotherapy (ECT) in treating anorectal tumors, focusing on its effectiveness, feasibility, and associated toxicities. ECT, which combines chemotherapy with the application of an electric field to enhance drug uptake by tumor cells, has shown promise as a local treatment, particularly in cases where conventional therapies such as radiotherapy have been exhausted or are unsuitable. The review, conducted according to SANRA guidelines, included 18 studies, on ECT in anorectal tumors, ranging from preclinical trials in dogs to case reports and clinical studies in humans. The findings indicate that ECT can achieve high tumor overall response rates (70-100%) with minimal side effects, offering benefits such as tumor reduction and preserved organ function. These results highlight the potential of ECT to provide not only tumor reduction but also the preservation of vital organ function with a relatively low toxicity profile. However, further comparative research is necessary to substantiate its role as a standard therapeutic option. Moreover, the evidence is limited by significant heterogeneity across studies, small sample sizes, and a lack of comparative research with other local treatments like radiotherapy and cryosurgery. Consequently, while ECT appears to be a promising option, particularly for palliative care or in a neoadjuvant setting, it cannot yet be recommended as a standard treatment. Future research should focus on larger, more robust studies with standardized outcomes and explore the potential synergy between ECT and other therapies to establish its place in the treatment of anorectal tumors.
本叙述性综述探讨了电化学疗法（ECT）在治疗肛管直肠肿瘤中的潜在作用，重点关注其有效性、可行性及相关毒性。ECT将化疗与电场应用相结合，以增强肿瘤细胞对药物的摄取，已显示出作为一种局部治疗方法的潜力，特别是在放疗等传统疗法已用尽或不适用的情况下。根据SANRA指南进行的这项综述纳入了18项关于ECT治疗肛管直肠肿瘤的研究，范围从犬类的临床前试验到人类的病例报告和临床研究。研究结果表明，ECT能够以最小的副作用实现较高的肿瘤总体缓解率（70%-100%），带来肿瘤缩小和保留器官功能等益处。这些结果凸显了ECT不仅能缩小肿瘤，还能以相对较低的毒性特征保留重要器官功能的潜力。然而，需要进一步的比较研究来证实其作为标准治疗选择的作用。此外，证据受到研究间显著异质性、小样本量以及缺乏与放疗和冷冻手术等其他局部治疗方法的比较研究的限制。因此，虽然ECT似乎是一个有前景的选择，特别是在姑息治疗或新辅助治疗中，但目前尚不能推荐其作为标准治疗方法。未来的研究应聚焦于更大规模、更稳健且具有标准化结果的研究，并探索ECT与其他疗法之间的潜在协同作用，以确立其在肛管直肠肿瘤治疗中的地位。
