电穿孔是众所周知的现象,当细胞暴露于高强度电脉冲时,会发生在细胞膜上。根据电脉冲幅度和脉冲数,应用的电穿孔可以是可逆的,膜通透性恢复或不可逆。可逆电穿孔用于将药物或遗传物质引入细胞而不影响细胞活力。电化学疗法是指联合治疗:电穿孔和药物注射以增强博来霉素的细胞毒性作用高达1000倍。几年来,电化学疗法作为微创肿瘤治疗越来越受欢迎。在介入肿瘤学中采用电化学疗法提出了几个未解决的问题,由于合适的肿瘤组织学和大小以及治疗效果仍需加深。电化学疗法通常用于姑息性治疗,用于治疗不可切除的肿瘤患者,以减轻疼痛并改善生活质量。在大多数情况下,当无法进行根治性手术治疗时,它可用于治疗晚期肿瘤(例如,由于病变位置,尺寸,和/或数字)。Further,电化学疗法允许在血管和神经等重要结构附近治疗肿瘤结节,因为治疗不涉及组织加热。总的来说,电化学疗法的安全性是有利的。大多数观察到的不良事件是局部和短暂的,中度局部疼痛,红斑,水肿,和电穿孔时的肌肉收缩。本文的目的是回顾最近发表的在深层肿瘤中使用电化学疗法的临床经验,尤其是肝脏病例。简要介绍了电化学疗法的原理以及在皮肤转移中的应用。对骨转移治疗的简短见解,无法切除的胰腺癌,并给予软组织肉瘤。讨论了电化疗对肝脏病变的治疗效果以及所采用方法的安全性的临床前和临床研究。
Electroporation is a well-known phenomenon that occurs at the cell membrane when cells are exposed to high-intensity electric pulses. Depending on electric pulse amplitude and number of pulses, applied electroporation can be reversible with membrane permeability recovery or irreversible. Reversible electroporation is used to introduce drugs or genetic material into the cell without affecting cell viability. Electrochemotherapy refers to a combined treatment: electroporation and drug injection to enhance its cytotoxic effect up to 1000-fold for bleomycin. Since several years, electrochemotherapy is gaining popularity as minimally invasive oncologic treatment. The adoption of electrochemotherapy procedure in interventional oncology poses several unsolved questions, since suitable tumor histology and size as well as therapeutic efficacy still needs to be deepen. Electrochemotherapy is usually applied in palliative settings for the treatment of patients with unresectable tumors to relieve pain and ameliorate quality of life. In most cases, it is used in the treatment of advanced stages of neoplasia when radical surgical treatment is not possible (eg, due to lesion location, size, and/or number). Further, electrochemotherapy allows treating tumor nodules in the proximity of important structures like vessels and nerves as the treatment does not involve tissue heating. Overall, the safety profile of electrochemotherapy is favorable. Most of the observed adverse events are local and transient, moderate local pain, erythema, edema, and muscle contractions during electroporation. The aim of this article is to
review the recent published clinical experiences of electrochemotherapy use in deep-seated tumors with particular focus on liver cases. The principle of electrochemotherapy as well as the application to cutaneous metastases is briefly described. A short insight in the treatment of bone metastases, unresectable pancreas cancer, and soft tissue sarcoma will be given. Preclinical and clinical studies on treatment efficacy with electrochemotherapy of hepatic lesions and safety of the procedure adopted are discussed.