Electrochemotherapy - possible benefits and limitations to its use in the head and neck region

Acta Otolaryngol. 2015 Jan;135(1):90-5. doi: 10.3109/00016489.2014.947655.

Abstract

Conclusion: Electrochemotherapy (ECT) is an efficacious treatment. It should, however, be used with some caution in the treatment of head and neck cancer.

Objectives: To assess local tumor control, safety, survival, and functional outcome after treatment of cancer in the head and neck region with ECT.

Methods: Four patients with primary T2 cancer of the oral cavity or oropharynx and one patient with a metastasis of renal cancer in the masseter muscle were treated with ECT with intratumorally administered bleomycin. Control biopsies were carried out 2 months after treatment. Postoperative radiotherapy was performed based on tumor T-stage and the depth of tumor infiltration. Serious adverse events and treatment malfunctions were recorded. The follow-up time was 24 months for the surviving patients and 20 months overall. The PSS-HN scale was used to assess the functional outcome.

Results: No local recurrence was recorded in any patient during the follow-up. However, only one patient was treated with ECT alone. There were four serious adverse events: one nearly lethal bleeding, two cases of osteoradionecrosis, and a fistula. One patient died from distant metastasis. The other patients were tumor-free both locally and overall at 24 months. The median functional outcome in all parameters was worse 1 year after treatment.

Keywords: Electroporation therapy; bleomycin; head and neck cancer; local control; serious adverse events; survival.

MeSH terms

  • Adenocarcinoma, Clear Cell / drug therapy*
  • Adenocarcinoma, Clear Cell / mortality
  • Adenocarcinoma, Clear Cell / secondary
  • Aged
  • Antibiotics, Antineoplastic / therapeutic use*
  • Bleomycin / therapeutic use*
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Electrochemotherapy / adverse effects*
  • Follow-Up Studies
  • Humans
  • Kidney Neoplasms / pathology
  • Male
  • Masseter Muscle
  • Middle Aged
  • Mouth Neoplasms / drug therapy*
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Recovery of Function
  • Treatment Outcome

Substances

  • Antibiotics, Antineoplastic
  • Bleomycin