■电化学疗法(ECT)利用电脉冲增强细胞毒性药物向肿瘤的递送,并已进入医疗设备以治疗表面转移性黑色素瘤。我们进行了系统评价和荟萃分析,以评估治疗模式和患者预后。
■PubMed,Medline,Embase,和Cochrane图书馆数据库从开始到2020年9月被查询出版。主要结果指标是总体和完全缓解率(ORR和CRR);次要结果包括局部控制率(LCR)和总生存期(OS)。
27项研究符合总共1161名个体(平均年龄71岁)和5308例肿瘤(加权平均大小14毫米)的选择标准。大多数患者(n=1124)接受了博来霉素-ECT。总ORR为77.6%(95%置信区间[CI]71.0-83.2%),CRR为48%(95%CI42-54%),博来霉素给药途径之间没有显着差异(ORR,69.2vs.81.9%在静脉注射或瘤内博莱霉素后,p=.37)和肿瘤大小(p=.69)。当报告时(n=8项研究),1年和2年LCR范围为54%至89%和72%至74%,分别,1年OS(n=3项研究)从67%提高到89%。
■ECT与肿瘤内或静脉内博来霉素在皮肤转移性黑色素瘤中赋予高治疗反应。适度的证据支持其低毒性和局部控制的持久性。重点电化学疗法(ECT)与77%的总反应率(ORR)相关。静脉和肿瘤内博莱霉素同样有效。没有相关的毒性问题。一年局部肿瘤控制率为54%至89%。目前的文献在报道方面有很大的差异。
UNASSIGNED: Electrochemotherapy (ECT) harnesses electric pulses to enhance cytotoxic drug delivery into tumors and has entered the armamentarium to treat superficially metastatic melanoma. We performed a systematic
review and meta-analysis to assess treatment patterns and patient outcomes.
UNASSIGNED: PubMed, Medline, Embase, and the Cochrane Library databases were queried for publication from inception to September 2020. Primary outcome measures were overall and complete response rate (ORR and CRR); secondary outcomes included local control rate (LCR) and overall survival (OS).
UNASSIGNED: Twenty-seven studies met the selection criteria for a total of 1161 individuals (mean age 71 years) and 5308 tumors (weighted mean size 14 mm). The majority of patients (n = 1124) underwent bleomycin-ECT. Aggregate ORR was 77.6% (95% confidence interval [CI] 71.0 - 83.2%) and CRR 48% (95% CI 42 - 54%), with no significant difference between the route of bleomycin administration (ORR, 69.2 vs. 81.9% following intravenous or intratumoral bleomycin, p = .37) and tumor size (p = .69). When reported (n = 8 studies), 1- and 2-year LCR ranged from 54 to 89% and 72 to 74%, respectively, and 1-year OS (n = 3 studies) from 67 to 89%.
UNASSIGNED: ECT with either intratumoral or intravenous bleomycin confers a high therapeutic response in cutaneous metastatic melanoma. Moderate evidence supports its low toxicity and durability of local control.HighlightsElectrochemotherapy (ECT) is associated with a 77% overall response rate (ORR).Intravenous and intratumoral bleomycin are equally effective.There are no relevant toxicity concerns.One-year local tumor control rate ranges from 54 to 89%.Current literature has significant variation in reporting.