title: Management of cutaneous metastases using electrochemotherapy.
abstract: BACKGROUND
  Cutaneous metastases may cause considerable discomfort as a consequence of ulceration, oozing, bleeding and pain. Electrochemotherapy has proven to be highly effective in the treatment of cutaneous metastases. Electrochemotherapy utilises pulses of electricity to increase the permeability of the cell membrane and thereby augment the effect of chemotherapy. For the drug bleomycin, the effect is enhanced several hundred-fold, enabling once-only treatment. The primary endpoint of this study is to evaluate the efficacy of electrochemotherapy as a palliative treatment.
  
  
  METHODS
  This phase II study is a collaboration between two centres, one in Denmark and the other in the UK. Patients with cutaneous metastases of any histology were included. Bleomycin was administered intratumourally or intravenously followed by application of electric pulses to the tumour site.
  
  
  RESULTS
  Fifty-two patients were included. Complete and partial response rate was 68% and 18%, respectively, for cutaneous metastases <3 cm and 8% and 23%, respectively, for cutaneous metastases >3 cm. Treatment was well-tolerated by patients, including the elderly, and no serious adverse events were observed.
  
  
  CONCLUSIONS
  ECT is an efficient and safe treatment and clinicians should not hesitate to use it even in the elderly.
authors.affiliation: Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Denmark.
authors.forename: Louise Wichmann
authors.initials: LW
authors.lastname: Matthiessen
authors.forename: Richard Ling
authors.initials: RL
authors.lastname: Chalmers
authors.forename: David Christopher George
authors.initials: DC
authors.lastname: Sainsbury
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Veeramani
authors.forename: Gareth
authors.initials: G
authors.lastname: Kessell
authors.forename: Alison Claire
authors.initials: AC
authors.lastname: Humphreys
authors.forename: Jane Elisabeth
authors.initials: JE
authors.lastname: Bond
authors.forename: Tobian
authors.initials: T
authors.lastname: Muir
authors.forename: Julie
authors.initials: J
authors.lastname: Gehl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D053672:Electrochemotherapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010166:Palliative Care; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome; D006113:United Kingdom