Electrochemotherapy of mucosal head and neck tumors: a systematic review

Figures & data

Figure 1. Electrochemotherapy on head and neck tumors.

Figure 2. PRISMA flow chart depicting the search and screening process.

Table 1. Overview of included studies.

	Study	Study design	No. of patients in each study	No. of patients with transmucosal ECT treatments
1	Allegretti and Panje 2001 [30]	Phase II clinical trial	14	12
2	Bloom and Goldfarb 2005 [31]	2 x phase II clinical trial	54	4*
3	Burian et al. 2003 [32]	Phase II clinical trial	12	12
4	Campana et al. 2014 [33]	Retrospective study	39	12
5	Gargiulo et al. 2012 [34]	Retrospective study	25	2
6	Landström et al. 2015 [35]	Phase II clinical trial	19	19
7	Landström et al. 2015 [36]	Phase II clinical trial	1	1**
8	Mevio et al. 2012 [37]	Phase II clinical trial	15	1
9	Seccia et al. 2014 [38]	Retrospective study	9	3
10	Skarlatos et al. 2011 [39]	Prospective study	52	4
11	Tijink et al. 2006 [40]	Report of case series	7	2
		Total	247	72

*The article describes side effects to mucosal ECT in 4 patients, but does not list the exact number of patients treated across the mucosa. **The study treats 5 patients in total but 4 of them are included in Study 6 [35]. ECT: electrochemotherapy.

Reasons for studies not mentioned in Table 1: Data mentioned twice: [41] mentioned [34]; [42], [43] and [44] mentioned in [30]; [45] mentioned in [35].

Table 2. Description of side effects in each included article.

Study	No. of cases	Side effects described
1	1	Osteomyelitis
	3	Dysphagia
	1	Pharyngo-cutaneous fistula
	1	Septum perforation (Panje and Sadeghi 2000 [43])
2	5	Bleeding – 1 died of bleeding 53 days after treatment
	6	Cellulitis or infection
	1	Swelling of the tongue
	2	Cardiac arrhythmia
3	1	Tongue swelling
	2	Pain in treated area grade III
4	8	Localized mucositis
	7	Mucosal ulceration
	5	Minor bleeding from tumor site
5		ND for the mucosal tumors
6	1	Severe bleeding after 6 weeks*
	1	Fistula*
	2	Osteoradionecrosis*
	3	Scored lover on ‘Performance Status Scale for Head and Neck Cancer’ 1 year after ECT (T1-T2 tongue cancer)
	2	Still had feeding tube 1 year after (T1-T2 tongue cancer)
	1	Only swallow liquids (T1-T2 tongue cancer)
	5	Minor articulation indistinctiveness (T1-T2 tongue cancer)
	1	Post-operative tongue pain (T1-T2 tongue cancer)
7		Described and mentioned in Study 6*
8	1	Acute myocardial infarction and died 3 days after ECT Several described moderate pain
9	1	Infection in the treated area (floor of mouth) leading to septicemia causing death 45 days after ECT
	2	Tracheostomy
		Post-operative pain in several patients
10		ND
11		Nausea

ECT: electrochemotherapy; ND: not described.

*The same patients appear in both study 6 and 7.

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