Immediate results of electrochemotherapy for
malignant tumors of the skin and soft tissues,
cutaneous and subcutaneous metastases
of melanoma

Relevance: Surgical removal of locally advanced forms of skin cancer and multiple cutaneous and subcutaneous metastases of melanoma does not always provide satisfactory aesthetic, functional, and long-term results. The treatment outcomes depend on the size, shape, location, and some other characteristics of the tumor. The relapse rate after surgical removal of locally advanced skin cancer is 12.5-34%, and the long-term survival of patients with cutaneous and subcutaneous metastases of melanoma does not exceed 30%. Cutaneous and subcutaneous metastases of melanoma and some superficial tumors are usually initially inoperable. Their complications such as bleeding, infection, pain, and pitting cause serious clinical problems and often require local therapy even at the 4th stage of the disease. Electrochemotherapy (ECT) is one of the modern treatment methods for skin cancer, soft tissue sarcoma, and metastatic melanoma. ECT is a treatment of choice in the presence of contraindications to surgical and radiation therapy. ECT combines the physical properties of current-induced electroporation with the chemical properties of chemotherapeutic drugs. In this method, an electric current affecting the tissue causes a temporary increase in cell membrane permeability, thereby providing free access to the cell of large molecules, including cytostatic drugs, which are not initially transferred to the cytosol. This significantly increases the potential toxicity of cytostatic drugs. The purpose of this study was to demonstrate the immediate results of ECT in patients with malignant tumors of the skin, soft tissue, cutaneous, and subcutaneous melanoma metastases. Results: Since 2017, 27 patients were treated by ECT at the Centre for bone and soft tissue tumors and melanomas of Kazakh Institute of Oncology and Radiology (Almaty, Kazakhstan). After two months, 67% of patients had a complete response (CR), 26% – a partial response (PR), and 7% had progression of the tumor. Side effects included local edema (n=13, 40%) which independently disappeared within several days to 2 weeks, local pains (12%) which disappeared within six months in 3% and within a month after treatment in 11%, and hyperthermia in the early postoperative period in 6% of patients which was stopped within 10-15 min after the procedure.

Download Full-text

Immediate results of electrochemotherapy for malignant tumors of the skin and soft tissues, cutaneous and subcutaneous metastases of melanoma

Oncologia i radiologia Kazakhstana ◽

10.52532/2521-6414-2020-2-56-31-34 ◽

2020 ◽

Vol 56 (2) ◽

pp. 31-34

Author(s):

D. A. Tuleuova ◽

G. A. Serikbaev ◽

A. K. Kurmanaliev ◽

J. U. Pysanova ◽

Sh. P. Najibulo ◽

...

Keyword(s):

Skin Cancer ◽

Soft Tissue ◽

Malignant Tumors ◽

Cell Membrane Permeability ◽

Long Term Results ◽

Temporary Increase ◽

Surgical Removal ◽

Term Survival ◽

Subcutaneous Metastases

Relevance: Surgical removal of locally advanced forms of skin cancer and multiple cutaneous and subcutaneous metastases of melanoma does not always provide satisfactory aesthetic, functional, and long-term results. The treatment outcomes depend on the size, shape, location, and some other characteristics of the tumor. The relapse rate after surgical removal of locally advanced skin cancer is 12.5-34%, and the long-term survival of patients with cutaneous and subcutaneous metastases of melanoma does not exceed 30%. Cutaneous and subcutaneous metastases of melanoma and some superficial tumors are usually initially inoperable. Their complications such as bleeding, infection, pain, and pitting cause serious clinical problems and often require local therapy even at the 4th stage of the disease. Electrochemotherapy (ECT) is one of the modern treatment methods for skin cancer, soft tissue sarcoma, and metastatic melanoma. ECT is a treatment of choice in the presence of contraindications to surgical and radiation therapy. ECT combines the physical properties of current-induced electroporation with the chemical properties of chemotherapeutic drugs. In this method, an electric current affecting the tissue causes a temporary increase in cell membrane permeability, thereby providing free access to the cell of large molecules, including cytostatics, which are not initially transferred to the cytosol. This significantly increases the potential toxicity of cytostatics. The purpose of this study was to demonstrate the immediate results of ECT in patients with malignant tumors of the skin, soft tissue, cutaneous, and subcutaneous melanoma metastases. Results: Since 2017, 27 patients were treated by ECT at the Centre for bone and soft tissue tumors and melanomas of Kazakh Institute of Oncology and Radiology (Almaty, Kazakhstan). After two months, 67% of patients had a complete response (CR), 26% – a partial response (PR), and 7% had progression of the tumor. Side effects included local edema (n=13, 40%) which independently disappeared within several days to 2 weeks, local pains (12%) which disappeared within six months after treatment in 3% and within a month in 11% of patients, and hyperthermia in the early postoperative period in 6% of patients which was stopped within 10-15 min after the procedure

Download Full-text

Long-term results of preoperative intra-arterial doxorubicin combined with neoadjuvant radiotherapy, followed by extensive surgical resection for locally advanced soft tissue sarcomas of the extremities

Radiotherapy and Oncology ◽

10.1016/s0167-8140(99)00003-1 ◽

1999 ◽

Vol 51 (1) ◽

pp. 15-19 ◽

Cited By ~ 20

Author(s):

Paul H.A. Nijhuis ◽

Elisabeth Pras ◽

Dirk Th. Sleijfer ◽

Wilhelmina M. Molenaar ◽

Heimen Schraffordt Koops ◽

...

Keyword(s):

Soft Tissue ◽

Surgical Resection ◽

Locally Advanced ◽

Soft Tissue Sarcomas ◽

Long Term Results ◽

Neoadjuvant Radiotherapy

Download Full-text

Long-term results of treatment for patients with locally advanced external ear skin cancer

Head and neck tumors (HNT) ◽

10.17650/2222-1468-2021-11-1-12-23 ◽

2021 ◽

Vol 11 (1) ◽

pp. 12-23

Author(s):

A. M. Mudunov ◽

E. G. Khazarova ◽

M. V. Bolotin

Keyword(s):

Skin Cancer ◽

Temporal Bone ◽

Locally Advanced ◽

Progression Free Survival ◽

Long Term Results ◽

External Ear ◽

Complex Treatment ◽

Free Survival ◽

Results Of Treatment

The study objective is to assess long-term results of treatment for patients with locally advanced external ear skin cancer.Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are 45 patients, who received treatment in surgical department of head and neck tumors in Blokhin National Medical Research Center of Oncology between 1994 and 2020. Patient observation time averaged 30.0 ± 32.3 months (from 0.7 to 117.4 months, median 12.0 months). We divided patients into 3 groups depending on treatment methods. Group 1 consisted of patients who received combined or complex treatment (33.3 %, n = 15). Treatment for first group patients involved subtotal, lateral temporal bone resection or incomplete lateral resection and postoperative radiation therapy on the area of primary tumor and regional metastasis zone (total focal dose from 60 Gy). In the case of complex treatment, radiation therapy had carried out against background cisplatin introduction. The second group consisted of patients who received only surgical treatment (40.0 %, n = 18). Temporal bone resections were not performed for patients of the third group (26.7 %, n = 12). Treatment for patients of the third group involved one of the treatment methods: cryodestruction, laser destruction, photodynamic therapy, radiotherapy or chemoradiation treatment.Results. Five-year survival without signs of progression in a group of patients with locally advanced of the ear skin cancer, who received combined or complex treatment was 73.8 ± 13.1. Median progression-free survival not achieved. In the surgical treatment group 5 year progression-free survival was 40.4 ± 13.0, median was 34.1 months. In a group of patients who did not undergo temporal bone resection (3rd group) median progression-free survival was 4.5 months. Group differences are statistically significant (p <0.05). The most significant adverse prognosis factors that reduce overall survival for patients with locally advanced external ear skin cancer are positive histological margin (p = 0.0001, hazard ratio (HR) = 10.611, 95 % confidence interval (CI) 3.058-36.820), signs of destruction branch of the lower jaw/ zygomatic bone (p = 0.027, HR = 4.65, 95 % CI 1.193-18.116). Facial paralysis is the most unfavorable prognosis factor, reducing tumor-specific survival in patients with locally advanced outer ear skin cancer (p = 0.0001, HR = 19.146, 95 % CI 4.056-90.388).Conclusion. Combined/complex treatment of patients with locally advanced ear skin cancer (surgery with postoperative radiotherapy/chemoradiotherapy) provides better long-term results compared to other treatment options.

Download Full-text

BLOOD SUPPLY FEATURES OF SOFT TISSUE SARCOMAS OF THE EXTREMITIES

Problems in oncology ◽

10.37469/0507-3758-2017-63-5-770-775 ◽

2017 ◽

Vol 63 (5) ◽

pp. 770-775

Author(s):

Mikhail Khanevich ◽

Georgiy Manikhas ◽

Anton Khazov ◽

M. Kukanov

Keyword(s):

Soft Tissue ◽

Blood Supply ◽

Soft Tissues ◽

Soft Tissue Sarcomas ◽

Disease Free Survival ◽

Long Term Results ◽

Surgical Removal ◽

Selective Embolization ◽

Results Of Treatment

Surgical removal of tumor remains the only one radical treatment for patients with soft tissue sarcomas of the extremities. However, the parameters of total and disease-free survival after this type of treatment cannot be considered satisfactory. Currently the active search and introduction into clinical practice of additional impact methods that can improve the immediate and long-term results of treatment of such patients is being conducted. In the article there are presented results of the analysis of preoperative angiographic studies of 94 patients with primary and recurrent sarcomas of soft tissues of the extremities. The features of blood supply and internal angioarchitectonics of tumor were revealed depending on the size, histological type and localization. The features of blood supply of tumors in patients with primary and recurrent sarcomas of soft tissues of extremities were described in detail. The results of further surgical treatment of patients included in the study showed that information on the number and size of blood supply sources of the tumor zone, supplemented by selective embolization of vessels, made it possible to select the optimal plan and minimize trauma, reduce intraoperative hemorrhage, and perform organ-preserving and functionally beneficial operations.

Download Full-text