Electrochemotherapy in Mucosal Cancer of the Head and Neck: A Systematic Review.
Primož Strojan, Aleš Grošelj, Gregor Serša, Christina Caroline Plaschke, Jan B Vermorken, Sandra Nuyts, Remco de Bree, Avraham Eisbruch, William M Mendenhall, Robert Smee, Alfio Ferlito
Author Information
Primož Strojan: Department of Radiation Oncology, Institute of Oncology Ljubljana and Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia. ORCID
Aleš Grošelj: Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana and Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
Gregor Serša: Department of Experimental Oncology, Institute of Oncology Ljubljana and Faculty of Health Sciences, University of Primorska, Izola and Faculty of Health Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia. ORCID
Christina Caroline Plaschke: Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark. ORCID
Jan B Vermorken: Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, and Department of Medical Oncology, Antwerp University Hospital, 2650 Edegem, Belgium.
Sandra Nuyts: Department of Oncology, KU Leuven, University of Leuven and Department of Radiation Oncology, UZ Leuven, 3000 Leuven, Belgium. ORCID
Remco de Bree: Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, 3584 Utrecht, The Netherlands. ORCID
Avraham Eisbruch: Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109-5010, USA.
William M Mendenhall: Department of Radiation Oncology, University of Florida, Gainesville, FL 32610-0385, USA.
Robert Smee: Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, NSW 2031, Australia.
Alfio Ferlito: Coordinator of the International Head and Neck Scientific Group, 35100 Padua, Italy. ORCID
Electrochemotherapy (ECT) is a local ablative treatment that is based on the reversible electroporation and intracellular accumulation of hydrophilic drug molecules, which greatly increases their cytotoxicity. In mucosal head and neck cancer (HNC), experience with ECT is limited due to the poor accessibility of tumors. In order to review the experience with ECT in mucosal HNC, we undertook a systematic review of the literature. In 22 articles, published between 1998 and 2020, 16 studies with 164 patients were described. Curative and palliative intent treatment were given to 36 (22%) and 128 patients (78%), respectively. The majority of tumors were squamous cell carcinomas (79.3%) and located in the oral cavity (62.8%). In the curative intent group, complete response after one ECT treatment was achieved in 80.5% of the patients, and in the palliative intent group, the objective (complete and partial) response rate was 73.1% (31.2% and 41.9%). No serious adverse events were reported during or soon after ECT and late effects were rare (19 events in 17 patients). The quality-of-life assessments did not show a significant deterioration at 12 months post-ECT. Provided these preliminary data are confirmed in randomized controlled trials, ECT may be an interesting treatment option in selected patients with HNC not amenable to standard local treatment.
