A Case Series on Electrochemotherapy Outcomes in Nine Head and Neck Cancer Patients, Focusing on Symptoms and Tumour Size Reduction

Abstract

Introduction: Head and Neck Carcinomas (HNC) are a significant cancer burden in India and worldwide, often necessitating palliative care due to their locoregional relapse. Electrochemotherapy (ECT), a combination of electroporation and chemotherapy, has shown promise in treating cutaneous tumours and addressing the limitations of conventional therapies. Aim: To explore the effectiveness of ECT in a palliative setting for patients with recurrent, inoperable head and neck malignancies. Materials and Methods: This case series, conducted at Department of Head and Neck Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India from January 2020 to December 2022, included nine cases that met specific inclusion criteria. Patients unsuitable for standard palliative systemic chemotherapy and with a life expectancy exceeding six months were included. ECT followed European Standard Operating Procedures of Electrochemotherapy (ESOPE) guidelines, focusing on patients with measurable cutaneous or mucosal tumour lesions and excluding contraindications. The study assessed outcomes after three treatment sessions, including bleeding, pain, discharge and tumour size, and employed Response Evaluation Criteria in Solid Tumors (RECIST) criteria to evaluate overall responses. Results: The overall mean age of the subjects was 57.78±4.56 years, with males having a mean age of 58.4±4.2 years and females having a mean age of 56.9±4.8 years. The cases included nine individuals with the following tumour sites: Buccal mucosa 6 cases (66.67%), Parotid 1 case (11.11%), and Tongue 2 cases (22.23%). tumour-related bleeding reduced from 7 cases (77.78%) to 1 case (11.11%), and discharge decreased from 8 cases (88.89%) to 2 cases (22.22%) by the third week. Notably, 3 cases (33.33%) exhibited a complete response, another 3 cases (33.33%) demonstrated a partial response, and only 1 case (11.11%) experienced disease progression. Furthermore, 2 cases (22.22%) had stable disease. Conclusion: The ECT demonstrated effectiveness as a palliative option for recurrent, inoperable head and neck malignancies. This approach improved health measurements, reducing symptoms such as bleeding and discharge. A substantial proportion of patients achieved favourable treatment responses.

Keywords

• chemotherapy
• oncology
• treatment outcome