title: Electrochemotherapy of cutaneous metastastes from breast cancer in elderly patients: a preliminary report.
abstract: BACKGROUND
  The management of cutaneous metastases often represents a challenge because they may be widespread and may recur after radiotherapy or chemotherapy; breast cancer accounts for 51% of the total cases of cutaneous metastases. When surgical excision of chest wall recurrences is not possible and other local treatments such as radiotherapy or radiotherapy with hyperthermia fail, topical chemotherapy and electrochemotherapy (ECT) might be taken into account.ECT is a new local treatment of solid tumors which can be defined as the local potentiation, by means of permeabilizing electric pulses, of the antitumor activity of a non permeating anticancer drug with high intrinsic cytotoxicity.
  
  
  METHODS
  This prospective observational study took place throughout March 2010 to October 2011. Twelve consecutive elderly patients (1 man and 11 women, median age of 76 years) with regional or distant skin or subcutaneous metastases from breast cancer, with or without visceral disease, were included in the study. Patient enrollment was carried out according to the ESOPE criteria. Bleomycin administration was followed by the application of brief electric pulses to each tumor nodule within 8 min after intravenous infusion of the drug. Electric currents were delivered by means of a 2-3 cm long needle electrode according to lesion size. All treatments were performed using the CliniporatorTM device.
  
  
  RESULTS
  We observed Complete Response(CR) in 75.3% (107 metastases), Partial Response(PR) in 17% (24 metastases), no change in 7.7% (11 metastases) . No serious ECT-related adverse events were reported; adverse events consisted of pain in the treated area one to two days after treatment (1 patient, 8.3%) and ulceration of treated area (1 patient, 8.3%).
  
  
  CONCLUSIONS
  ECT could be suggested as a primary local therapy in patients not suitable for surgical removal of the primary tumor, and clinicians should not hesitate to use it even in the elderly.
authors.affiliation: Department of Medical, Surgical, Neurologic, Metabolic and Ageing Sciences, Second University of Naples, Naples, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Benevento
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoriello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Perna
authors.forename: Silvestro
authors.initials: S
authors.lastname: Canonico
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000473:pathology*; D018567:Breast Neoplasms, Male / Q000473:pathology; D053672:Electrochemotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin