A novel application of calcium electroporation to cutaneous manifestations of gynaecological cancer
Author(s)
Type
Journal Article
Abstract
Introduction: Calcium electroporation (CaEP) is a new technique whereby intracellular concentrations of calcium are elevated by transient permeabilisation of the cell membrane using high-voltage electrical pulses. Tumour necrosis is induced with little damage to healthy tissue. Within gynaecological cancer, vulval cancer and vulval intraepithelial neoplasia (VIN) pose challenges for treatment, given the high recurrence rate, persistent symptoms and repeated resections required. In certain cases, CaEP may provide a suitable alternative.
Methods: We present a case series of six patients with recurrent vulval squamous cell carcinoma(n=2), VIN III (n=2) and metastatic ovarian cancer (n=2), five of whom were treated with CaEP. This is the first known application of CaEP to gynaecological cancers .Results: The median follow-up time was 14 months (range 2-18 months). Within the cohort of patients, CaEP was applied a total of 10 times, achieving a complete response five times and partial response four times. Symptoms improved within six weeks for eight episodes following CaEP application. Beyond six weeks, symptoms eventually recurred in all patients and four patients required more than one CaEP procedure. CaEP was useful for palliation of distressing symptoms in one case of metastatic ovarian cancer. No intra-operative or post-operative complications have been reported to date. Conclusion: CaEP may be a promising short-term treatment in selected patients with recurrent VIN and vulval cancer, where other treatments had failed. If validated, it could provide an acceptable alternative where surgery is unacceptable. Long term follow-up is required to evaluate effects on recurrence.
Methods: We present a case series of six patients with recurrent vulval squamous cell carcinoma(n=2), VIN III (n=2) and metastatic ovarian cancer (n=2), five of whom were treated with CaEP. This is the first known application of CaEP to gynaecological cancers .Results: The median follow-up time was 14 months (range 2-18 months). Within the cohort of patients, CaEP was applied a total of 10 times, achieving a complete response five times and partial response four times. Symptoms improved within six weeks for eight episodes following CaEP application. Beyond six weeks, symptoms eventually recurred in all patients and four patients required more than one CaEP procedure. CaEP was useful for palliation of distressing symptoms in one case of metastatic ovarian cancer. No intra-operative or post-operative complications have been reported to date. Conclusion: CaEP may be a promising short-term treatment in selected patients with recurrent VIN and vulval cancer, where other treatments had failed. If validated, it could provide an acceptable alternative where surgery is unacceptable. Long term follow-up is required to evaluate effects on recurrence.
Date Issued
2021-08-15
Date Acceptance
2021-03-12
Citation
European Journal of Gynecological Oncology, 2021, 42 (42), pp.662-672
ISSN
0392-2936
Publisher
Innovative Medical Press
Start Page
662
End Page
672
Journal / Book Title
European Journal of Gynecological Oncology
Volume
42
Issue
42
Copyright Statement
©2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
License URL
Sponsor
Cancer Research UK
Cancer Research UK
Identifier
https://ejgo.imrpress.com/EN/10.31083/j.ejgo4204102
Grant Number
WSAA_P84261
16989
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
Obstetrics & Gynecology
Calcium
Electroporation
Ovarian cancer
Vulval cancer
VIN
ELECTROCHEMOTHERAPY
METASTASES
MANAGEMENT
1112 Oncology and Carcinogenesis
1115 Pharmacology and Pharmaceutical Sciences
1116 Medical Physiology
Oncology & Carcinogenesis
Publication Status
Published
Date Publish Online
2021-08-15