Basal cell carcinoma: 10-year experience with electrochemotherapy

Area of Science:

• Oncology
• Dermatology
• Medical Physics

Background:

• Electrochemotherapy (ECT) is an effective palliative therapy for skin conditions.
• It combines cytotoxic agents with electric pulses for targeted treatment.
• ECT is a safe alternative for basal cell carcinoma (BCC) patients ineligible for standard therapies, but long-term data is limited.

Purpose of the Study:

• To evaluate the efficacy and safety of bleomycin-based ECT for multiple, recurrent, or locally advanced BCC.
• To identify factors associated with treatment response in BCC patients undergoing ECT.
• To assess long-term outcomes, including recurrence rates, after ECT for BCC.

Main Methods:

• Retrospective analysis of 84 patients with BCC treated with bleomycin-based ECT (2006-2016).
• Patients had multiple, recurrent, or locally advanced BCC unsuitable for standard treatments.
• Data collected prospectively, analyzed retrospectively according to European Standard Operative Procedures.

Main Results:

• A 50% overall clearance rate was observed.
• Factors like primary presentation, smaller tumor size (<3 cm), well-defined borders, absence of ulceration, non-aggressive histology, and younger age (≤69 years) correlated with higher response rates.
• Clearance rates were 72.5% and 85% after one or two ECT cycles for local BCC, respectively. Objective response was achieved in 78% of locally advanced BCC cases.

Conclusions:

• Bleomycin-based ECT is a valuable palliative treatment for selected BCC patients with favorable tumor features.
• Further research is needed to validate predictive factors for optimal patient selection and ECT treatment.
• The management of locally advanced BCC (laBCC) using ECT requires additional investigation.