Medical Specialties

Electrochemotherapy. General Surgery

Electrochemotherapy is one of the most effective, low-cost, and non-invasive oncological treatments available. It is a method of introducing cytostatics into cancer cells by combining their injection into the tumor or bloodstream with an electrical pulse that directs these drugs to the cancer cells (a process called electroporation). A special probe sends an electrical impulse to the malignant tumor, causing the membrane of the cancer cell to change and form pores, allowing the drug to penetrate and intensify its action only on the cancer cells.

Cytostatics become available directly in cancer cells in this manner, which is why they are administered in much lower doses. In comparison to other traditional cancer treatment options, the main advantage of this procedure is that it leaves healthy tissue unaffected. Electrochemotherapy can reduce tumor mass, shrink affected lymph nodes, reduce or even eliminate local pain, and thus improve quality of life. The primary indication is as a palliative procedure when other treatment options have been exhausted or when tumors are inoperable.

 What types of cancer do they apply to?

Electrochemotherapy is primarily used to treat cancers that began in the skin or have spread to the skin. Skin cancers (both melanoma and non-melanoma), Kaposi's sarcoma, breast cancers, and vaginal or anal mucosa are examples. Basal cell carcinoma and squamous cell carcinoma that has not spread can be treated to cure them.

This technique, which has been used in Europe for over 25 years, has benefited from numerous clinical trials and even has a European treatment guide. Bleomycin and cisplatin are currently used in electrochemotherapy to treat skin metastases of various tumors, as well as inoperable primary tumors.

How effective is it?

Clinical trials have shown that electrochemotherapy is more effective than cytostatics alone. It is a promising procedure for cutaneous and non-cutaneous malignant tumors. Small tumors respond twice as well as large tumors, according to research. Furthermore, regardless of the type of tumor, it is a much cheaper, faster, and easier to tolerate technique because, at low doses of cytostatics, it has a low level of side effects and discomfort.

According to recent estimates, electrochemotherapy has an average efficacy of around 84 percent, whereas systemic chemotherapy has only a palliative role with response rates of less than 25 percent when used alone. Thus, electroporation proves to be a life-saving solution for more efficient administration of chemotherapeutic drugs in tumor cells. This method achieves a much higher intracellular concentration in bleomycin or cisplatin tumor cells while using doses up to 10,000 times lower than in chemotherapy regimens, significantly improving antitumor efficacy and preserving the integrity of normal cells that chemotherapy no longer penetrates.

What exactly is the procedure?

General or local anesthesia is used for intratumoral injection, followed by the administration of the cytostat and the transmission of the electrical impulse. General anesthesia is usually administered for intravenous injections. The intravenous chemotherapeutic is administered, and the electrical impulse is delivered to the tumor after 8 minutes. The CLINIPORATOR device sends the pulse through a pen-shaped probe equipped with an electrode. The electrode is inserted into the tumor by the doctor to discharge the electrical impulse on the tumor. Depending on the number of tumors, the treatment can take 30-60 minutes.

Bleomycin and cisplatin are the chemotherapeutic agents used, with bleomycin being the most commonly used. When the maximum safe dose of bleomycin has been reached or if the patient has experienced bleomycin side effects, cisplatin may be an option.

This procedure usually does not necessitate hospitalization.

Side effects and risks

The most common side effect is a pain in the treated area and surrounding muscles. This type of pain is usually mild and lasts for a few days. Some people experience more severe pain that can last for 2-4 weeks. During treatment, some people experience muscle contractions. Others may experience mild nausea and vomiting as a result of treatment; however, antiemetic medications may be prescribed. Signs of inflammation, such as redness, pain, or fluid leakage (plasma), may occur in rare cases. Fever is also possible. In a very small number of cases, patients may develop an allergic reaction to cytostatics. Serious side effects are extremely rare, but as with any medical intervention, they cannot be ruled out.