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Bertino G, Groselj A, Campana LG, Kunte C, Schepler H, Gehl J, Muir T, Clover JAP, Quaglino P, Kis E, Mascherini M, Bisase B, Pecorari G, Bechara F, Matteucci P, Odili J, Russano F, Orlando A, Pritchard-Jones R, Moir G, Mowatt D, Silvestri B, Seccia V, Saxinger W, de Terlizzi F, Sersa G. Electrochemotherapy for the treatment of cutaneous squamous cell carcinoma: The INSPECT experience (2008-2020). Front Oncol 2022; 12:951662. [PMID: 36203425 PMCID: PMC9531998 DOI: 10.3389/fonc.2022.951662] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/26/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Cutaneous squamous cell carcinoma (cSCC) is a frequent skin cancer with a high risk of recurrence characterized by tumor infiltration and, in advanced cases, a poor prognosis. ECT (electrochemotherapy) is an alternative treatment option for locally advanced or recurrent cSCC that is unsuitable for surgical resection. In this study, we aimed to evaluate the data in the InspECT (International Network for Sharing Practice on ECT) registry of the referral centers and to clarify the indications for the use of ECT as a treatment modality for cSCC. Materials and methods Patients with primary, recurrent or locally advanced cSCC from 18 European centers were included. They underwent at least one ECT session with bleomycin between February 2008 and November 2020, which was performed following the European Standard Operating Procedures. Results The analysis included 162 patients (mean age of 80 years; median, 1 lesion/patient). Side effects were mainly local and mild (hyperpigmentation, 11%; ulceration, 11%; suppuration, 4%). The response to treatment per patient was 62% complete and 21% partial. In the multivariate model, intravenous drug administration and small tumor size showed a significant association with a positive outcome (objective response). One-year local progression-free survival was significantly better (p<0.001) in patients with primary tumors (80% (95% C.I. 70%-90%) than in patients with locally advanced disease (49% (95% C.I. 30%-68%). Conclusion In the present study, ECT showed antitumor activity and a favorable safety profile in patients with complex cSCC for whom there was no widely accepted standard of care. Better results were obtained in primary and small tumors (<3 cm) using intravenous bleomycin administration.
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Affiliation(s)
- Giulia Bertino
- Department of Otolaryngology Head Neck Surgery, University of Pavia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo Foundation, Pavia, Italy
| | - Ales Groselj
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Luca G. Campana
- Department of Surgery, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Christian Kunte
- Department of Dermatosurgery and Dermatology, Artemed Fachklinik Munich, München, Germany
| | - Hadrian Schepler
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (CEDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tobian Muir
- Department of Reconstructive Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - James A. P. Clover
- Department of Plastic Surgery, Cork University Hospital, Cork, Ireland
- Cancer Research @UCC, University College Cork, Cork, Ireland
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Erika Kis
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Matteo Mascherini
- Department of Surgical Sciences, Polyclinic Hospital San Martino, Genoa, Italy
| | - Brian Bisase
- Clinic for Head and Neck Cancer, Queen Victoria Hospital National Health Service (NHS) Foundation Trust, East Grinstead, United Kingdom
| | - Giancarlo Pecorari
- Department of Surgical Sciences, Otolaryngology Clinic, University of Turin, Turin, Italy
| | - Falk Bechara
- Department of Dermatologic Surgery, Ruhr-University Bochum, Bochum, Germany
| | - Paolo Matteucci
- Dept Plastic Surgery, Hull University Teaching Hospitals National Health Service (NHS) Trust, Hull, United Kingdom
| | - Joy Odili
- Department of Plastic Surgery, St. Georges University Hospitals National Health Service (NHS) Trust, London, United Kingdom
| | - Francesco Russano
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy
| | - Antonio Orlando
- Southmead Hospital, North Bristol National Health Service (NHS) Trust, Department of Plastic and Reconstructive Surgery, Bristol, United Kingdom
| | - Rowan Pritchard-Jones
- Plastic Reconstructive Surgery, University of Liverpool, St. Helens & Knowsley Teaching Hospitals National Health Service (NHS) Trust, Liverpool, United Kingdom
| | - Graeme Moir
- Department of Cutaneous Medicine and Surgery, The Royal London Hospital & Queen Mary University of London (QMUL), Bart’s Health National Health Service (NHS) Trust, London, United Kingdom
| | - David Mowatt
- Department of Surgery, Christie Hospital, Manchester, United Kingdom
| | - Barbara Silvestri
- Oncology and Haematology Unit, Azienda Unità Sanitaria Locale Socio Sanitaria (AULSS) 3 Serenissima-Mirano, Venice, Italy
| | - Veronica Seccia
- Otorhinolaryngology Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
| | - Werner Saxinger
- Department of Dermatology, Klinikum Wels-Grieskirchen, Wels, Austria
| | | | - Gregor Sersa
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
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