Electrochemotherapy for non-melanoma head and neck cancers: Clinical outcomes in 25 patients

Objective: To evaluate and confirm the efficacy and safety of electrochemotherapy (ECT) using bleomicyn in a large series of non-melanoma head and neck cancers. Background: ECT combines chemotherapy and electroporation to increase drug uptake into cancer cells. ECT has proven to be effective in the treatment of tumor nodules of cutaneous and subcutaneous localization. Up to now, this therapy has been mainly used as a local control of melanoma skin metastasis. Few studies have focused on its role in the treatment of head and neck cutaneous and subcutaneous cancers. Methods: Twenty-five patients underwent ECT for the treatment of non-melanoma head and neck cancers. All tumors were classified by histological type (confirmed by biopsy), size, and TNM Classification of Malignant Tumors (TNM). Treatments were performed using a bolus of bleomicyn and a pulse generator under local or general anesthesia after the ESOPE (European Standard Operating Procedures of Electrochemotherapy) standard operating procedures. Results: An objective response was achieved in 100% of treated patients (n = 25) at 6 weeks after the initial treatment. The complete response rate according to the WHO criteria was 72% (n = 18); the partial response rate was 28% (n = 7). None of the lesions that achieved a complete response relapsed after a median follow-up period of 18 months. Partial responders showed stable disease for the duration of the follow-up. Conclusions: In accordance with the clinical results shown, we encourage further investigation to establish ECT's use as first line treatment especially in basocellular carcinomas of the head and neck area and for squamocellular carcinomas of the lip with no detectable cervical lymphoadenopathy.