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Abstract：
The main treatment of MM metastases are systemic therapies, surgery, limb perfusion, and intralesional talimogene laherparepvec. Electrochemotherapy (ECT) is potentially useful also due to the high response rates recorded in cancers of any histology. No randomized studies comparing ECT with other local therapies have been published on this topic. We analyzed the available evidence on efficacy and toxicity of ECT in this setting. PubMed, Scopus, and Cochrane databases were screened for paper about ECT on MM skin metastases. Data about tumor response, mainly in terms of overall response rate (ORR), toxicity (both for ECT alone and in combination with systemic treatments), local control (LC), and overall survival (OS) were collected. The methodological quality was assessed using a 20-item validated quality appraisal tool for case series. Overall, 18 studies were included in our analysis. In studies reporting \"per patient\" tumor response the pooled complete response (CR) was 35.7% (95%CI 26.0-46.0%), and the pooled ORR was 80.6% (95%CI 68.7-90.1%). Regarding \"per lesion\" response, the pooled CR was 53.5% (95%CI 42.1-64.7%) and the pooled ORR was 77.0% (95%CI 56.0-92.6%). One-year LC rate was 80%, and 1-year OS was 67-86.2%. Pain (24.2-92.0%) and erythema (16.6-42.0%) were the most frequent toxicities. Two studies reported 29.2% and 41.6% incidence of necrosis. ECT is effective in terms of tumor response and tolerated in patients with skin metastases from MM, albeit with a wide variability of reported results. Therefore, prospective trials in this setting are warranted.
摘要：
MM转移的主要治疗方法是全身治疗，手术,肢体灌注,和病变内胎骨拉赫帕累夫。由于在任何组织学的癌症中记录的高响应率，电化学疗法（ECT）也可能有用。尚未就该主题发表比较ECT与其他局部疗法的随机研究。我们分析了在这种情况下ECT疗效和毒性的现有证据。PubMed,Scopus,和Cochrane数据库筛选有关ECT对MM皮肤转移的论文。有关肿瘤反应的数据，主要是总体反应率(ORR)，毒性（单独使用ECT和与全身治疗联合使用），本地控制（LC），收集总生存期(OS)。使用案例系列的20个项目经过验证的质量评估工具评估了方法学质量。总的来说,18项研究纳入我们的分析。在报告“每位患者”肿瘤反应的研究中，合并完全缓解（CR）为35.7％（95CI26.0-46.0％），合并的ORR为80.6%(95CI68.7-90.1%)。关于“每个病变”的反应，合并CR为53.5%(95CI42.1-64.7%),合并ORR为77.0%(95CI56.0-92.6%).一年期LC率为80%,1年OS为67-86.2%。疼痛（24.2-92.0％）和红斑（16.6-42.0％）是最常见的毒性。两项研究报告了29.2%和41.6%的坏死发生率。ECT对MM皮肤转移患者的肿瘤反应和耐受性有效，尽管报告的结果差异很大。因此,有必要在这种情况下进行前瞻性试验.
