European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results of the treatment of skin cancer.
Electrochemotherapy is an effective and safe method for local treatment of cutaneous and subcutaneous tumours, where electric pulses cause increased permeability of cell membranes in the tumour mass, enabling dramatically enhanced effectiveness of bleomycin and other hydrophilic drugs. Here, we report results of a European multi-institutional prospective study of the effectiveness of electrochemotherapy in the treatment of skin cancer of the head and neck (HN) area, where standard treatments had either failed or were not deemed suitable or declined by the patient. A total of 105 patients affected by primary or recurrent skin cancer of the HN area were enrolled; of these, 99 were eligible for evaluation of tumour response. By far, the majority (82%) were treated only once, and 18% of patients had a second treatment. The objective response was highest for basal cell carcinoma (97%) and for other histologies was 74%. Small, primary, and treatment-naive carcinomas responded significantly better (p < 0.05), as investigated by univariate analysis. Electrochemotherapy was well tolerated and led to a significant improvement of quality of life, estimated by the European Organisation for Research and Treatment of Cancer quality of life questionnaires. At 1-year follow-up, the percentages of overall and disease-free survival were 76% and 89%, respectively. Electrochemotherapy is an effective option for skin cancers of the HN area and can be considered a feasible alternative to standard treatments when such an alternative is appropriate. The precise role for electrochemotherapy in the treatment algorithm for non-melanoma skin cancer of the HN region requires data from future randomised controlled studies. (ISRCTN registry N. 30427).
Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, P.le Golgi 2, 27100, Pavia, Italy. Electronic address: giulia.bertino@tin.it.
Giulia
G
Bertino
Institute of Oncology Ljubljana, Zaloska 2, SI-1000, Ljubljana, Slovenia. Electronic address: gsersa@onko-i.si.
Gregor
G
Sersa
IGEA Clinical Biophysics Department, Via Parmenide 10/A, Carpi, 41012, Modena, Italy. Electronic address: f.deterlizzi@igeamedical.com.
Francesca
F
De Terlizzi
Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, P.le Golgi 2, 27100, Pavia, Italy. Electronic address: antonio.occhini@alice.it.
Antonio
A
Occhini
Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen, Denmark. Electronic address: caroline@dadlnet.dk.
Christina Caroline
CC
Plaschke
Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloska 2, Ljubljana, SI-1000, Slovenia. Electronic address: ales.groselj@hotmail.com.
Ales
A
Groselj
Department of Otolaryngology Head Neck Surgery - Oncologic Service Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. Electronic address: clangdon@clinic.ub.es.
Cristobal
C
Langdon
Department of Otolaryngology Head Neck Surgery - Oncologic Service Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. Electronic address: jjgrau@clinic.ub.es.
Juan J
JJ
Grau
Head and Neck Unit, Royal Marsden Hospital London, Fulham Rd, London, SW3 6JJ, UK; Maxillofacial Unit London Northwest Healthcare Trust, UK. Electronic address: jim.mccaul@mac.com.
James A
JA
McCaul
Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands. Electronic address: d.heuveling@vumc.nl.
Derrek
D
Heuveling
Institute of Oncology Ljubljana, Zaloska 2, SI-1000, Ljubljana, Slovenia. Electronic address: MCemazar@onko-i.si.
Maja
M
Cemazar
Institute of Oncology Ljubljana, Zaloska 2, SI-1000, Ljubljana, Slovenia. Electronic address: pstrojan@onko-i.si.
Primoz
P
Strojan
Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands. Electronic address: R.deBree@umcutrecht.nl.
Remco
R
de Bree
Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands. Electronic address: cr.leemans@vumc.nl.
C Renè
CR
Leemans
Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen, Denmark. Electronic address: Irene.Wessel.01@regionh.dk.
Irene
I
Wessel
Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Oncology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark. Electronic address: karen.julie.gehl@regionh.dk.
Julie
J
Gehl
Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, P.le Golgi 2, 27100, Pavia, Italy. Electronic address: m.benazzo@smatteo.pv.it.
Marco
M
Benazzo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000188:drug therapy*; D053672:Electrochemotherapy / Q000379:methods*; D005060:Europe; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy*
Basal cell carcinoma; Electrochemotherapy; Head and neck; Malignant melanoma; Quality of life; Squamous cell carcinoma