title: The controversial role of electrochemotherapy in head and neck cancer: a systematic review of the literature.
abstract: Electroporation, also known as electrochemotherapy, combines an antineoplastic agent with electroporation, causing localized progressive necrosis in the treated area. Today it is primarily used in the palliative treatment of cutaneous and subcutaneous metastases and has been found to be safe and efficacious in head and neck cancer recurrences. Despite the steady increase in the number of published studies this treatment is not universally available and used systematically in head and neck carcinomas. To shed light on its limitations and analyze treatment outcome we have, therefore, reviewed all available literature regarding this topic. This systematic review includes 16 studies on head and neck squamous cell carcinoma and reports the data of 200 treated patients. The combined results show a very heterogeneous overall response rate, ranging from 0 to 100%, while the complete response rate ranges between 0 and 83.3%. No major side effects have been described in those who used electrochemotherapy as a mono modality palliative treatment. This systematic review shows how standardization of treatment is still pivotal to achieve a more homogeneous response rate in the approach to head and neck tumors. In conclusion, due to the scarcity of alternatives of treatment in advanced stage cancer in this anatomical region and the good tolerability and mostly high success rates of electrochemotherapy, this palliative approach should be taken into consideration in these patients.
authors.affiliation: Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Apuane Hospital, Massa, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lenzi
authors.affiliation: Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Apuane Hospital, Massa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Muscatello
authors.affiliation: Unit of Otolaryngology, ASST Santi Paolo e Carlo Hospital, Milan, Italy.
authors.forename: Alberto Maria
authors.initials: AM
authors.lastname: Saibene
authors.affiliation: Unit of Otolaryngology, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Via Antonio di Rudinì 8, 20142, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Felisati
authors.affiliation: Unit of Otolaryngology, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Via Antonio di Rudinì 8, 20142, Milan, Italy. carlotta.pipolo@unimi.it.
authors.forename: Carlotta
authors.identifier: http://orcid.org/0000-0001-6628-2117
authors.initials: C
authors.lastname: Pipolo
mesh_terms: D053672:Electrochemotherapy / Q000009:adverse effects / Q000379:methods; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy; D006801:Humans; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods; D016896:Treatment Outcome
keywords: Electrochemotherapy; Electroporation; Head and neck cancer; Palliative treatment; Squamous cell carcinoma; Tumor