title: Electrochemotherapy - possible benefits and limitations to its use in the head and neck region.
abstract: CONCLUSIONS
  Electrochemotherapy (ECT) is an efficacious treatment. It should, however, be used with some caution in the treatment of head and neck cancer.
  
  
  OBJECTIVE
  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.
authors.affiliation: Departments of Otolaryngology.
authors.forename: Fredrik J
authors.initials: FJ
authors.lastname: Landström
authors.forename: Johan A
authors.initials: JA
authors.lastname: Reizenstein
authors.forename: Christer O S
authors.initials: CO
authors.lastname: Nilsson
authors.forename: Mathias Von
authors.initials: MV
authors.lastname: Beckerath
authors.forename: A Lennart
authors.initials: AL
authors.lastname: Löfgren
authors.forename: Gun-Britt
authors.initials: GB
authors.lastname: Adamsson
authors.forename: Claes
authors.initials: C
authors.lastname: Möller
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D053672:Electrochemotherapy / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008297:Male; D008406:Masseter Muscle; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin
keywords: Electroporation therapy; bleomycin; head and neck cancer; local control; serious adverse events; survival