The role of electrochemotherapy with intratumoral bleomycin for early tongue carcinoma

Abstract

Background

The role of electrochemotherapy (ECT) using intratumoral bleomycin and electroporation as a first line treatment for oral tongue carcinoma has not been defined.

Aims/Objectives

To evaluate the method of ECT in oral tongue carcinoma.

Material and Methods

Twenty-one successive patients with primary T1-T2 oral cancer predominantly of the oral tongue underwent either ECT (test; n = 9), or standard surgical resection and reconstruction (control; n = 12). Outcome variables were: local recurrence rates, 10-year-survival, adverse events, treatment cost, and quality of life.

Results

The 10-year local recurrence rate (44.4%) was higher and the tumour-specific survival rate (55.6%) was lower in the ECT group compared to the control group (17% and 91.6%, respectively). Postoperative haemorrhage, dysphagia, and pain were more frequent in ECT patients, treatment time was shorter, but treatment cost was higher. Quality of life was not improved by ECT.

Conclusions and Significance

Our results indicate that ECT seems not as suitable for the treatment of early tongue cancer as it is for neoplastic and metastatic skin lesions and less favourable than standard surgical therapy.

Chinese abstract

背景：使用肿瘤内博来霉素和电穿孔作为口腔舌癌的一线治疗, 这种电化疗法（ECT）的作用尚未明确。

目的：评价ECT治疗口腔舌癌的方法。

材料和方法：21例以原发性T1-T2口腔舌癌为主的连续口腔癌患者接受ECT（测试； n¼9）或标准手术切除和重建（对照； n¼12）。结果变量为：局部复发率、10年生存率、不良反应事件、治疗费用和生活质量。

结果：与对照组相比, ECT组的10年局部复发率更高（44.4％）, 而肿瘤特异性生存率更低（55.6％）。对照组的分别为17％和91.6％。ECT患者的术后出血、吞咽困难和疼痛更为常见, 治疗时间较短, 但治疗费用较高。 ECT并未改善生活质量。

结论和意义：我们的结果表明ECT似乎不适用于治疗早期舌癌, 更适用于肿瘤性和转移性皮肤病变的治疗。ECT不如标准手术治疗。

Keywords:

• Oral cancer
• squamous cell carcinoma
• head and neck
• electrochemotherapy
• bleomycin

Disclosure statement

The authors declare that there is no conflict of interest.

Additional information

Funding

Patients of the test group were part of an ECT multicentre trial registered as EU-HNBE-2003 supported by Genetronics Inc., San Diego, CA.