<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0009_s_005_w2aab3b8c21b1b7b1aab1c16b1Aa"><h3>Background</h3><p>Electrochemotherapy (ECT) is a local cancer treatment based on electroporation where the electric field is used to enhance cell membrane permeability and thereby facilitating the transition of chemotherapeutic agents into the cell. For the treatment of non-melanoma skin cancer, a standard dosage of 15,000 IU/m<sup>2</sup> bleomycin (BLM) is used. The aim of the present study was to evaluate the long-term ECT response in the group of elderly patients with non-melanoma skin cancer treated with a reduced dose of BLM in comparison to the outcome in the patients treated with the standard dose of BLM.</p></sec><sec id="j_raon-2020-0009_s_006_w2aab3b8c21b1b7b1aab1c16b2Aa"><h3>Patients and methods</h3><p>Twenty-eight patients older than 65 years, with a total of 52 non-melanoma skin lesions were included in the study. Twelve patients (24 lesions) in the experimental group received a reduced dose of BLM (10,000 IU/m<sup>2</sup>), 16 patients (28 lesions) were treated with a standard dose of BLM (15,000 IU/m<sup>2</sup>).</p></sec><sec id="j_raon-2020-0009_s_007_w2aab3b8c21b1b7b1aab1c16b3Aa"><h3>Results</h3><p>No statistically significant difference in tumor control was observed between both groups. In the experimental group, tumors recurred in 39.0% of treated lesions in a median follow-up time of 28 months. In the control group, the recurrence rate of treated lesions was 15.4% in a median follow-up time of 40 months.</p></sec><sec id="j_raon-2020-0009_s_008_w2aab3b8c21b1b7b1aab1c16b4Aa"><h3>Conclusions</h3><p>ECT with a reduced dose of BLM is a feasible treatment option for elderly patients with equal efficacy to standard dose treatment and should be considered as a treatment modality in advanced aged patients with comorbidities, where overall life expectancy is poor.</p></sec></abstract>

BackgroundElectrochemotherapy (ECT) is a local cancer treatment based on electroporation where the electric field is used to enhance cell membrane permeability and thereby facilitating the transition of chemotherapeutic agents into the cell. For the treatment of non-melanoma skin cancer, a standard dosage of 15,000 IU/m2 bleomycin (BLM) is used. The aim of the present study was to evaluate the long-term ECT response in the group of elderly patients with non-melanoma skin cancer treated with a reduced dose of BLM in comparison to the outcome in the patients treated with the standard dose of BLM.Patients and methodsTwenty-eight patients older than 65 years, with a total of 52 non-melanoma skin lesions were included in the study. Twelve patients (24 lesions) in the experimental group received a reduced dose of BLM (10,000 IU/m2), 16 patients (28 lesions) were treated with a standard dose of BLM (15,000 IU/m2).ResultsNo statistically significant difference in tumor control was observed between both groups. In the experimental group, tumors recurred in 39.0% of treated lesions in a median follow-up time of 28 months. In the control group, the recurrence rate of treated lesions was 15.4% in a median follow-up time of 40 months.ConclusionsECT with a reduced dose of BLM is a feasible treatment option for elderly patients with equal efficacy to standard dose treatment and should be considered as a treatment modality in advanced aged patients with comorbidities, where overall life expectancy is poor.

Long term response of electrochemotherapy with reduced dose of bleomycin in elderly patients with head and neck non-melanoma skin cancer

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundElectrochemotherapy (ECT) is a local cancer treatment based on electroporation where the electric field is used to enhance cell membrane permeability...

Patient	Gender	Age (years)	Creatinine (μmol/L)	Total bleomycin dose (IU)	Electrodes used	Last follow-up (months after ECT)	Histology	Maximum tumor size (mm)	Recurrence of tumor (months after ECT)
1	M	65	68	30,000	Needle row	39	BCC	22
2	F	74	86	26,000	Needle row	55	BCC	15
3	M	83	129	28,000	Plate	19 *	BCC	12
							BCC	32	7
							BCC	10	7
4	M	81	78	27,000	Needle row	37	BCC	10
							BCC	5
							BCC	6
							BCC	4
5	F	82	73	24,000	Plate	41	BCC	9	6
							BCC	5
							BCC	11
6#	M	88	142	30,000	Plate	2	BCC	39
7	F	69	84	23,000	Finger	46	BCC	15
8	F	82	DM	24,000	Hexagonal	41	BCC	50
							BCC	7
							BCC	20	18
9	F	89	69	23,000	Plate	48	BCC	6
							BCC	5
							BCC	6
10	M	65	DM	27,000	Plate	31	BCC	24
11#	F	70	DM	27,000	Plate	4	BCC	7
12	M	78	DM	23,000	Plate	46	BCC	15
13	F	74	52	24,000	Needle row	38	BCC	15
14	F	89	54	25,000	Plate	48	BCC	21
14	F	89	54	25,000	Plate	48		BCC	22
15	M	67	DM	30,000	Plate	11	SCC	25
16	M	85	100	24,000	Needle row	15 *	SCC	45

Patient	Gender	Age (years)	Creatinine (μmol/L)	Total bleomycin dose (IU)	Electrodes used	Last follow up (months after ECT)	Histology	Maximum tumor size (mm)	Recurrence of tumor (months after ECT)
1	M	86	84	20,000	Needle row	30	BCC BCC	20 8
2	M	67	108	24,000	Needle row	29	BCC BCC	10 8
3	M	80	106	21,000	Needle row	20	BCC	30	10
4#	M	82	66	20,000	Needle row	2 *	SCC SCC SCC	10 6 10
5	M	92	88	20,000	Needle row	25	BCC BCC BCC	25 15 15	2525
6	M	79	67	20,000	Plate	34	BCC BCC BCC BCC	80 20 20 10	24
7	F	78	83	20,000	Needle row	30	BCC	15
8#	M	76	144	21,000	Needle row	6 *	SCC SCC SCC	20 27 35
9	F	86	74	17,500	Needle row	19 *	BCC	25
10	M	80	81	21,000	Needle row	28	BCC	10	13
11	M	85	42	20,000	Needle row	24 *	BCC	50	3
12	M	83	94	19,000	Needle row	28	BCC SCC	7 7	4

Long term response of electrochemotherapy with reduced dose of bleomycin in elderly patients with head and neck non-melanoma skin cancer

Article Category: Research Article

Published Online: Feb 19, 2020

Page range: 79 - 85

Received: Dec 15, 2019

Accepted: Feb 04, 2020

DOI: https://doi.org/10.2478/raon-2020-0009

© 2020 Crt Jamsek, Gregor Sersa, Masa Bosnjak, Ales Groselj, published by sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Patients’ characteristics, treatment procedure and response to treatment of patients included in control group

Patients’ characteristics, treatment procedure and response to treatment of patients included in experimental group