Effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reaction
Objectives: To evaluate the efficacy and tolerance after the electrochemotherapy treatment for local therapy of cutaneous and subcutaneous metastases of head-and-neck tumors and malignant melanoma refractory to standard therapies, mainly in neck metastasis of squamous cell carcinoma. And, to evaluat...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1808869423001337 |
| _version_ | 1797346047634178048 |
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| author | Miguel Caballero-Borrego Sandra Coll Pilar Navarrete |
| author_facet | Miguel Caballero-Borrego Sandra Coll Pilar Navarrete |
| author_sort | Miguel Caballero-Borrego |
| collection | DOAJ |
| description | Objectives: To evaluate the efficacy and tolerance after the electrochemotherapy treatment for local therapy of cutaneous and subcutaneous metastases of head-and-neck tumors and malignant melanoma refractory to standard therapies, mainly in neck metastasis of squamous cell carcinoma. And, to evaluate the relation of this response according to the skin reaction (healing with ulcer or dry crust). Methods: prospective pase II, observational clinical study of 56 patients with metastases of head-and-neck squamous cell carcinoma (n = 13), papillary thyroid carcinoma (n = 4), adenoid cystic carcinoma of parotid gland (n = 1) or malignant melanoma (n = 37, 5 in head). Patients were treated by electrochemotherapy (application of electrical pulses into the tumor) after the administration of a single intravenous dose of bleomycin. Kaplan-Meier curves were performed. The statistical significance was evaluated using log-rank test; p-value of less than 0.05 was considered as significant. Results: Overall clinical response was observed in 47 patients (84%). Local side effects were mild in all the patients. Ten patients (76.9%) with neck metastasis of squamous cell carcinoma had some degree of response, but only in one was complete. Patients even with only partial response had a higher overall survival than patients without response (p = 0.02). Most of the patients with squamous cell carcinoma had diminution of pain and anxiety. Response rate and overall survival was higher in MM patients (86.5%) than in squamous cell cancer patients (76.9%) (p = 0.043). The healing process (dry crust/ulcer) was not associated with the overall survival (p = 0.86). Conclusions: Electrochemotherapy is associated a higher overall survival and diminution of pain and anxiety. Therefore, it is an option as palliative treatment for patients with neck metastasis of squamous cell carcinoma refractory to other therapies or even as a concomitant treatment with newer immunotherapies. The type of healing of the surgical wound could not be associated with a higher rate of response or survival. Level of evidence: III. |
| first_indexed | 2024-03-08T11:26:07Z |
| format | Article |
| id | doaj.art-c0feb6e6134c4f50b2d3e8aa0603d340 |
| institution | Directory Open Access Journal |
| issn | 1808-8694 |
| language | English |
| last_indexed | 2024-03-08T11:26:07Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj.art-c0feb6e6134c4f50b2d3e8aa0603d3402024-01-26T05:32:39ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942024-01-01901101365Effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reactionMiguel Caballero-Borrego0Sandra Coll1Pilar Navarrete2Hospital Clínic Barcelona, Department of Otorhinolaryngology, Universitat de Barcelona, Barcelona, Spain; Corresponding author.Hospital Clínic Barcelona, Department of Otorhinolaryngology, Universitat de Barcelona, Barcelona, SpainUniversitat de Barcelona, Department of Medicine, Barcelona, SpainObjectives: To evaluate the efficacy and tolerance after the electrochemotherapy treatment for local therapy of cutaneous and subcutaneous metastases of head-and-neck tumors and malignant melanoma refractory to standard therapies, mainly in neck metastasis of squamous cell carcinoma. And, to evaluate the relation of this response according to the skin reaction (healing with ulcer or dry crust). Methods: prospective pase II, observational clinical study of 56 patients with metastases of head-and-neck squamous cell carcinoma (n = 13), papillary thyroid carcinoma (n = 4), adenoid cystic carcinoma of parotid gland (n = 1) or malignant melanoma (n = 37, 5 in head). Patients were treated by electrochemotherapy (application of electrical pulses into the tumor) after the administration of a single intravenous dose of bleomycin. Kaplan-Meier curves were performed. The statistical significance was evaluated using log-rank test; p-value of less than 0.05 was considered as significant. Results: Overall clinical response was observed in 47 patients (84%). Local side effects were mild in all the patients. Ten patients (76.9%) with neck metastasis of squamous cell carcinoma had some degree of response, but only in one was complete. Patients even with only partial response had a higher overall survival than patients without response (p = 0.02). Most of the patients with squamous cell carcinoma had diminution of pain and anxiety. Response rate and overall survival was higher in MM patients (86.5%) than in squamous cell cancer patients (76.9%) (p = 0.043). The healing process (dry crust/ulcer) was not associated with the overall survival (p = 0.86). Conclusions: Electrochemotherapy is associated a higher overall survival and diminution of pain and anxiety. Therefore, it is an option as palliative treatment for patients with neck metastasis of squamous cell carcinoma refractory to other therapies or even as a concomitant treatment with newer immunotherapies. The type of healing of the surgical wound could not be associated with a higher rate of response or survival. Level of evidence: III.http://www.sciencedirect.com/science/article/pii/S1808869423001337ElectrochemotherapyHead and neck cancerMalignant melanomaPalliative treatmentBleomycinHealing response |
| spellingShingle | Miguel Caballero-Borrego Sandra Coll Pilar Navarrete Effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reaction Brazilian Journal of Otorhinolaryngology Electrochemotherapy Head and neck cancer Malignant melanoma Palliative treatment Bleomycin Healing response |
| title | Effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reaction |
| title_full | Effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reaction |
| title_fullStr | Effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reaction |
| title_full_unstemmed | Effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reaction |
| title_short | Effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reaction |
| title_sort | effectiveness and tolerance of electrochemotherapy as palliative therapy for patients with head and neck cancer and malignant melanoma and its relation to early skin reaction |
| topic | Electrochemotherapy Head and neck cancer Malignant melanoma Palliative treatment Bleomycin Healing response |
| url | http://www.sciencedirect.com/science/article/pii/S1808869423001337 |
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