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Palliative Electrochemotherapy in Vulvar Carcinoma: Preliminary Results of the ELECHTRA (Electrochemotherapy Vulvar Cancer) Multicenter Study

1
Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy
2
Radiation Oncology Centre, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy
3
Department of Obstetrics and Gynaecology, ASST Lecco Ospedale Manzoni, Via dell’Eremo 9/11, 23900 Lecco, Italy
4
General and Oncologic Surgery Unit, Department of Surgical and Biomedical sciences, Ospedale Santa Maria della Misericordia, University of Perugia, Piazza Menghini, 1, 06129 Perugia, Italy
5
Scientific & Medical Department IGEA S.p.A. Via Parmenide 10/A, 41012 Carpi (Mo), Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Cancers 2019, 11(5), 657; https://doi.org/10.3390/cancers11050657
Received: 22 March 2019 / Revised: 7 May 2019 / Accepted: 9 May 2019 / Published: 12 May 2019
(This article belongs to the Collection Drug Resistance and Novel Therapies in Cancers)
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Abstract

Vulvar cancer (VC) is a rare disease of which recurrence poses management problems due to patients’ advanced age and comorbidities, and to the localization of the disease. Palliative treatments, allowing local disease control in patients previously treated with multimodal therapies or with comorbidities, are lacking. In this study we tested electrochemotherapy (ECT) on recurrent VC refractory to standard therapies to assess the tumor response and to define the selection criteria for patient’s candidate to ECT. This is a multicenter observational study carried out in five Italian centers. Data about patients and tumor characteristics, treatment, toxicity, and clinical response were recorded. In all procedures, intravenous bleomycin was administered according to European Standard Operative Procedure ECT (ESOPE) guidelines. Sixty-one patients, with a median age 79 years (range: 39–85) and mainly affected by squamous cellular carcinoma (91.8%), were treated with ECT. No serious adverse events were reported. Patients were discharged after three days (median, range: 0–8 days). Two months after ECT, the clinical response rate was 83.6% and was not related to age, body mass index, International Federation of Gynecology and Obstetrics (FIGO) stage, number of treated nodules, or previous treatments. ECT is a safe procedure with a favorable cost-effectiveness ratio and should be considered as a treatment option for local disease control in patients unsuitable for standard therapies. View Full-Text
Keywords: vulvar cancer; recurrence; electrochemotherapy; bleomycin; palliative therapy vulvar cancer; recurrence; electrochemotherapy; bleomycin; palliative therapy
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MDPI and ACS Style

Perrone, A.M.; Galuppi, A.; Pirovano, C.; Borghese, G.; Covarelli, P.; De Terlizzi, F.; Ferioli, M.; Cara, S.; Morganti, A.G.; De Iaco, P. Palliative Electrochemotherapy in Vulvar Carcinoma: Preliminary Results of the ELECHTRA (Electrochemotherapy Vulvar Cancer) Multicenter Study. Cancers 2019, 11, 657.

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