Electrochemotherapy as a symptom-oriented palliative treatment option: an exploratory single-center study in 15 patients with locally advanced or locoregionally recurrent vulvar carcinoma
Abstract
Background
Vulvar carcinoma (VC), a rare cancer, recurs in over a third of women, usually within 2 years. Treatment options other than repeat surgery and radiotherapy are often required in the recurrence setting. Systemic chemotherapy is an option but is generally associated with stressful side effects. In the palliative setting, electrochemotherapy (ECT) is a better-tolerated alternative, which provides local tumor control while obviating systemic side effects.
Objective
To descriptively analyze a case series of patients with inoperable locally advanced or locoregionally recurrent VC receiving bleomycin-based ECT.
Methods
Descriptive analysis of prospectively collected data from a case series. Postmenopausal women with locally advanced or locoregionally recurrent VC were eligible for inclusion. Bleomycin was administered at 15 mg/m 2 body surface as a single 1-min intravenous injection; 8 min later, electrochemical treatment using sterile disposable electrodes was performed under anesthesia for ≤ 30 min. Postoperatively, patients received pain medication to mitigate muscle soreness.
Results
15 patients were included in the study. Median patient age at ECT was 81 (range, 51–100) years. Recurrences (1–5) were present in 12 patients. Surgery and radiotherapy were not justifiable options in 3 patients. In our clinical observation, ECT was well tolerated by all patients for the management of pain, itching, odor, and secretion. This allowed for time to be gained until further treatment became necessary or disease progression occurred.
Conclusions
In our clinical experience, bleomycin-based ECT is an oncologically efficacious and better-tolerated alternative to systemic chemotherapy or immunotherapy in patients with recurrent VC in a palliative setting with limited capacity to undergo treatment.