After having removed the initial appearance of a tumour the cancer can reocccur (metastasize) to the skin or in other sites on the body. It is always important to treat metastases to prevent progression and improve a patient’s quality of life.
To date, electrochemotherapy has been predominantly used to treat skin metastases with a success rate of over 80%.
The main skin clinical indications of electrochemotherapy are:
– Cutaneous metastases from melanoma or other tumours
– Epitheliomas (basal cell and spinocellular carcinomas)
– Kaposi’s sarcoma
– Gorlin-Goltz syndrome
– Eccrino porocarcinoma
– Bowen’s disease.
Breast cancer occurs in one in eight women throughout life. It is the most common cancer in women, accounting for 29% of all cancers affecting women.
After having removed the tumor at is first appearance, in some cases the disease may progress to further skin spread, metastases, both near the site of tumor removal, and in a skin area not near the surgically treated breast.
In these cases, combining with a systemic therapy an effective local control of the cutaneous disease the survival rate increases to 15 years by 4.9%.
Electrochemotherapy is indicated for the local control of the cutaneous spread of the disease regardless of the type of primary tumour (positive hormone, HER2 positive or triple negative), with a success rate of over 70%.
Vulvar carcinoma is a rare neoplasm and represents 4% of all gynaecological tumours.
It is more common in women over the age of 50 although cases of illness are also increasing in women aged 40 and younger.
The most common histological type of vulvar tumor is squamous cell carcinoma which consists of about 90% of diagnoses, followed by melanoma.
In respect of vulvar disease, electrochemotherapy can be useful in the following indications:
– Recurrences from squamous cell carcinoma
– Melanoma metastasis
– Paget’s disease.
HEAD AND NECK
Head and neck tumours can have serious consequences for the patient and can affect social life and normal daily activities.
Most of these tumours occur in males aged between 60 and 70 years. The most frequently affected sites are oral cavity, pharynx, larynx, nose and paranasal sinuses, salivary glands, thyroid gland, and nervous and lymphatic structures of the neck, ear and skin.
The main use of electrochemotherapy in the head and neck area are in the locally advanced primitive tumours and skin metastases not amenable with surgery.
In over 80% of cases electrochemotherapy controls the disease at local level and improves the patient’s quality of life.
80% of skeletal metastases derive from breast, prostate, lung, kidney and thyroid tumours.
The most affected sites are the vertebral column, pelvis, skull, femur and the humerus. In 75% of cases bone metastases are responsible for a variety of complications called related skeletal events (SRE) which worsen the patient’s quality of life.
Electrochemotherapy of bone metastases can slow or block the growth of metastatic cells and can control pain.
The liver, due to its function, is affected by metastases more frequently than primitive tumours.
Neoplasms or metastases located in the hepatic hilum and its vital structures (portal vein, hepatic artery, main biliary pathway, vena cava) are often difficult to manage with conventional techniques (surgery and thermal ablation).
Electrochemotherapy can be a valid option in these patients as by not using heat sources it kills tumoural cells and allows to protect noble structures surrounding the lesions and regenerate healthy tissue.
Surgical excision is the recommended treatment for this particular tumour.
In cases of late diagnosis the tumour can be locally advanced (stage III) and could have infiltrated some arterial vessels located in close proximity to the pancreas such as the superior mesenteric artery and the celiac trunk. In these cases surgery and other ablative techniques can be difficult to perform.
Electrochemotherapy can represent a valid alternative because, by not using heat sources, it allows protection of the noble structures surrounding the lesion and regenerates the healthy tissue instead of the neoplastic one.
Colorectal cancer represents the second most malignant tumour in women after breast cancer and in men the third after lung and prostate cancer.
In patients with a low-right metastatic tumour who are not eligible for palliative surgery, electrochemotherapy controls the disease locally, relieves symptoms, stops bleeding and improves patients’ quality of life.
In addition, electrochemotherapy can be used in cases of residual disease following treatment of the primary tumour with neoadjuvant chemotherapy or surgery.
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