Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: Analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry
Autor: | J. Odili, Roberto Marconato, Pietro Quaglino, Julie Gehl, Simone Ribero, Matteo Brizio, Luca Giovanni Campana, F. de Terlizzi, Christian Kunte, S.H. Liew, Roberta Rotunno, Pietro Curatolo |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Electrochemotherapy Skin Neoplasms Nausea medicine.medical_treatment Pain Breast Neoplasms Dermatology Bleomycin Disease-Free Survival 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Breast cancer Infectious Diseases Internal medicine medicine Carcinoma Humans Basal cell carcinoma Registries Melanoma Sarcoma Kaposi Aged Retrospective Studies Aged 80 and over Chemotherapy Antibiotics Antineoplastic business.industry medicine.disease Surgery Injection Site Reaction 030104 developmental biology Treatment Outcome chemistry Carcinoma Basal Cell 030220 oncology & carcinogenesis Carcinoma Squamous Cell Administration Intravenous Female Sarcoma medicine.symptom business |
Popis: | Background Electrochemotherapy (ECT) is currently used to treat unresectable superficial tumours of different histotypes through the combination of cytotoxic chemotherapy and local application of electric pulses. In 2006, a collaborative project defined the ESOPE (European Standard Operating Procedures of Electrochemotherapy) guidelines to standardize the procedure. The International Network for Sharing Practices of Electrochemotherapy (InspECT) aims to refine the ESOPE and improve clinical practice. Limiting patient exposure to systemic chemotherapy would be advisable to ameliorate ECT safety profile. Objective The aim of this study was to evaluate the efficacy and toxicity of ECT with reduced chemotherapy dosages. Methods In a retrospective analysis of a prospectively maintained database (InspECT registry), we evaluated the outcome of patients who received ECT with reduced dosages of bleomycin (7500, 10 000 or 13 500 IU/m2 , instead of the standard dose of 15 000 IU/m2 ). Tumour response in melanoma patients was compared with melanoma patients of the InspECT registry who received the standard dose of bleomycin. Results We identified 57 patients with 147 tumours (melanoma, 38.6%; squamous cell carcinoma, 22.8%; basal cell carcinoma, 17.5%; breast cancer 7%; Kaposi sarcoma 7%; other histotypes, 7.1%). Per-tumour complete response (CR) rate at 60 days was 70.1% (partial, 16.3%); per-patient CR was 57.9% (partial, 21.1%). Local pain was the most frequently reported side-effect (n = 22 patients [39%]), mostly mild; two patients experienced flu-like symptoms, one patient nausea. We observed the same CR rate (55%) in patients with melanoma treated by reduced or conventional bleomycin dosages (P = 1.00). Conclusions Electrochemotherapy performed with reduced bleomycin dosages could be as effective as with currently recommended dose. Patients with impaired renal function or candidate to multiple ECT cycles could benefit from a reduced dose protocol. Our findings need prospective confirmation before being adopted in clinical practice. |
Databáze: | OpenAIRE |
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