Head & Neck

The role of Electrochemotherapy in the treatment of patients with head and neck cancer

Rationale

Head and neck cancers are most often associated with squamous cell carcinoma. Patients often suffer with locally aggressive lesions and are at high risk of relapse. Current treatments can be disfi guring, invasive and can also involve loss of function.

IGEA Medical have developed specific electrodes for treating head and neck cancers with the CLINIPORATORTM. These include Finger and Adjustable electrodes to treat inaccessible areas and to prevent needle penetration of important nerves and vessels in the head and neck region.

Electrochemotherapy for head and neck cancer patients

Several clinical studies demonstrate the efficacy and safety of Electrochemotherapy treatment with the CLINIPORATORTM in head and neck cancer patients.

Electrochemotherapy for Head and neck cancer patients

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How effective is Electrochemotherapy?

The effectiveness of Electrochemotherapy appears to be driven by many factors, amongst these Campana et al and colleagues identify:

- Number and size of the lesions
- Anatomical location and accessibility

These considerations help to define which eligible patients could respond the best to the treatment and who will have better local progression-free survival and better survival overall.

Patients who show the best response to Electrochemotherapy

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NICE Guidance

NICE published guidance on Electrochemotherapy in March 2013, saying that it may reduce symptoms and improve quality of life for appropriately selected patients.
NICE has said that this procedure can be:
“offered routinely as a palliative treatment option for people with metastases in the skin from tumours of non-skin origin or melanoma...the procedure may reduce symptoms and improve quality of life for people with disease that cannot be treated with, or doesn’t respond to, other treatments.”

Electrochemotherapy in clinical practice

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These clinical images show treatment response in a patient with a large squamous cell carcinoma of the cheek (above) and in a patient with a recurrent carcinoma in the retromolar trigone (below).

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Conclusions

Treatment with Electrochemotherapy is appropriate for patients suffering with head and neck cancer. It is an effective tool for radical local disease control and can be used as a neo-adjuvant treatment. It can also be a first line treatment for locally advanced, challenging head and neck cancers. [4]

Local control of the disease has an important effect on quality of life. Electrochemotherapy can be considered an effective addition to the cancer treatment armamentarium.

Useful Links

Information & Support

References

1. Plaschke C. et al. European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results from the treatment of mucosal cancers. Eur J Cancer 2017; 87: 172-181.
2. Bertino G et al. European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results of the treatment of skin cancer. Eur J Cancer. 2016 Jun 4; 63: 41-52.
3. Montuori M et al. Electrochemotherapy for basocellular and squamocellular head and neck cancer: preliminary experience in day surgery unit. G Ital Dermatol Venereol. 2016 Jul 5.
4. Rotunno R et al. Electrochemoterapy in non-melanoma head and neck skin cancers: a three-center experience and review of the literature. G Ital Dermatol Venereol. 2015 Sep 16.
5. Campana LG et al. Electrochemotherapy in non-melanoma head and neck cancers: a retrospective analysis of the treated cases. BJOMS. 2014 Dec; 52(10):957-64.
6. Mevio N et al. Electrochemotherapy for the treatment of recurrent head and neck cancers: preliminary results. Tumori, 98: 308-313, 2012.
7. Gargiulo M et al. Electrochemotherapy for Non-Melanoma Head and Neck Cancers Clinical Outcomes in 25 Patients. Ann Surg 8. Skarlatos I et al. Electrochemotherapy in Cancer Patients: First Clinical Trial in Greece. in vivo 25: 265-274, 2011.

Further reading

- Seccia V et al. Electrochemotherapy and Its Controversial Results in Patients with Head and Neck Cancer. Anticancer Research 34:967-972. 2014.
- Macri GF et al. Use of electrochemotherapy in a case of neck skin metastasis of oral squamous cell carcinoma: Case report and considerations. Head & Neck. 2014 Sep;36(9):E86-90.
- Mali B et al. Antitumor effectiveness of electrochemotherapy: a systematic review and meta-analysis. Eur J Surg Oncol. 2013;
39(1): 4-16.
- Scelsi D et al. Electrochemotherapy as a new therapeutic strategy in advanced Merkel cell carcinoma of head and neck region. Radiol
Oncol 2013; 47(4): 366-369.
- Larkin JO et al. Electrochemotherapy, aspects of preclinical development and early clinical experience. Ann Surg, 245: 469-
479, 2007.
- Marty M et al. Electrochemotherapy – an easy, highly effective and safe treatment of cutaneous and subcutaneous metastases. Results of ESOPE (European Standard Operating Procedures of Electrochemotherapy) study. Eur J Cancer 4(Suppl):3-13, 2006.

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