PDF(Pubmed)
Abstract：
Electroporation with chemotherapy (ECT) is currently offered as a treatment in Europe for locoregional or metastatic melanoma with cutaneous lesions. However, the role of surgery and other forms of electroporation in melanoma requires further evaluation. Two reviewers used two databases to conduct a literature search and review, and 51 publications related to electroporation with chemotherapy, immunotherapy, or gene delivery were found. ECT appears to be effective in reducing tumor burden for surgical resection, replacing surgical intervention with evidence of complete regression in some lesions, and inducing both local and systemic immune effects. These immune effects are pronounced when ECT is combined with immunotherapy, with a statistically significant improvement in overall survival (OS). Other forms of electroporation, such as those using calcium chloride, an IL-12 plasmid, and vaccination, require further study. However, IL-12 plasmid electroporation may be inferior to ECT based on the evidence available. Furthermore, irradiation of the tumor prior to ECT treatment is negatively correlated with local response. Access to ECT is restricted in the US and requires further evaluation. More randomized controlled trials of ECT and electroporation treatment in locoregional melanoma are recommended.
摘要：
目前，在欧洲，通过化学疗法（ECT）进行电穿孔作为治疗皮肤病变的局部或转移性黑色素瘤的方法。然而,手术和其他形式的电穿孔在黑色素瘤中的作用需要进一步评估.两位审稿人利用两个数据库进行文献检索和综述,和51篇与化疗电穿孔相关的出版物，免疫疗法，或者发现基因传递。ECT似乎可以有效减少手术切除的肿瘤负担，用某些病变完全消退的证据代替手术干预，并诱导局部和全身免疫效应。当ECT与免疫治疗相结合时，这些免疫效应是明显的，总生存期（OS）有统计学上的显着改善。其他形式的电穿孔，比如那些使用氯化钙的，IL-12质粒，接种疫苗,需要进一步研究。然而,根据现有证据，IL-12质粒电穿孔可能不如ECT。此外，ECT治疗前肿瘤的照射与局部反应呈负相关。在美国，使用ECT受到限制，需要进一步评估。建议在局部黑色素瘤中进行更多的ECT和电穿孔治疗的随机对照试验。
