Electrochemotherapy: technological advancements for efficient electroporation-based treatment of internal tumors View Full Text


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Article Info

DATE

2012-11-21

AUTHORS

D. Miklavčič, G. Serša, E. Brecelj, J. Gehl, D. Soden, G. Bianchi, P. Ruggieri, C. R. Rossi, L. G. Campana, T. Jarm

ABSTRACT

Electrochemotherapy, a combination of high voltage electric pulses and of an anticancer drug, has been demonstrated to be highly effective in treatment of cutaneous and subcutaneous tumors. Unique properties of electrochemotherapy (e.g., high specificity for targeting cancer cells, high degree of localization of treatment effect, capacity for preserving the innate immune response and the structure of the extracellular matrix) are facilitating its wide spread in the clinics. Due to high effectiveness of electrochemotherapy in treatment of cutaneous and subcutaneous tumors regardless of histological origin, there are now attempts to extend its use to treatment of internal tumors. To advance the applicability of electrochemotherapy to treatment of internal solid tumors, new technological developments are needed that will enable treatment of these tumors in daily clinical practice. New electrodes through which electric pulses are delivered to target tissue need to be designed with the aim to access target tissue anywhere in the body. To increase the probability of complete tumor eradication, the electrodes have to be accurately positioned, first to provide an adequate extent of electroporation of all tumor cells and second not to damage critical healthy tissue or organs in its vicinity. This can be achieved by image guided insertion of electrodes that will enable accurate positioning of the electrodes in combination with patient-specific numerical treatment planning or using a predefined geometry of electrodes. In order to be able to use electrochemotherapy safely for treatment of internal tumors located in relative proximity of the heart (e.g., in case of liver metastases), the treatment must be performed without interfering with the heart’s electrical activity. We describe recent technological advances, which allow treatment of liver and bone metastases, soft tissue sarcomas, brain tumors, and colorectal and esophageal tumors. The first clinical experiences in these novel application areas of electrochemotherapy are also described. More... »

PAGES

1213-1225

References to SciGraph publications

  • 2011-03-06. Diffusion-Weighted MRI for Verification of Electroporation-Based Treatments in THE JOURNAL OF MEMBRANE BIOLOGY
  • 2009-06-25. Liver ablation techniques: a review in SURGICAL ENDOSCOPY
  • 2011-03-23. Food Preservation by Pulsed Electric Fields: An Engineering Perspective in FOOD ENGINEERING REVIEWS
  • 2010. Changes in Electrocardiogram during Intra-Abdominal Electrochemotherapy: A Preliminary Report in XII MEDITERRANEAN CONFERENCE ON MEDICAL AND BIOLOGICAL ENGINEERING AND COMPUTING 2010
  • 2008-04-16. The effect of electroporation pulses on functioning of the heart in MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING
  • 2010-02-23. Towards treatment planning and treatment of deep-seated solid tumors by electrochemotherapy in BIOMEDICAL ENGINEERING ONLINE
  • 2005-10-05. Image-guided ablation of painful metastatic bone tumors: a new and effective approach to a difficult problem in SKELETAL RADIOLOGY
  • 2010-07-09. Induced Transmembrane Voltage and Its Correlation with Electroporation-Mediated Molecular Transport in THE JOURNAL OF MEMBRANE BIOLOGY
  • 2010-03-21. Research on Industrial-Scale Electroporation Devices Fostering the Extraction of Substances from Biological Tissue in FOOD ENGINEERING REVIEWS
  • 2008-01-08. Vascular disrupting action of electroporation and electrochemotherapy with bleomycin in murine sarcoma in BRITISH JOURNAL OF CANCER
  • 2009-01-01. Bleomycin-Based Electrochemotherapy: Clinical Outcome from a Single Institution’s Experience with 52 Patients in ANNALS OF SURGICAL ONCOLOGY
  • 2008-05-23. Electrochemotherapy with Intravenous Bleomycin in the Local Treatment of Skin Melanoma Metastases in ANNALS OF SURGICAL ONCOLOGY
  • 1998-06. Effective treatment of cutaneous and subcutaneous malignant tumours by electrochemotherapy in BRITISH JOURNAL OF CANCER
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s11517-012-0991-8

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    http://dx.doi.org/10.1007/s11517-012-0991-8

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    25 schema:description Electrochemotherapy, a combination of high voltage electric pulses and of an anticancer drug, has been demonstrated to be highly effective in treatment of cutaneous and subcutaneous tumors. Unique properties of electrochemotherapy (e.g., high specificity for targeting cancer cells, high degree of localization of treatment effect, capacity for preserving the innate immune response and the structure of the extracellular matrix) are facilitating its wide spread in the clinics. Due to high effectiveness of electrochemotherapy in treatment of cutaneous and subcutaneous tumors regardless of histological origin, there are now attempts to extend its use to treatment of internal tumors. To advance the applicability of electrochemotherapy to treatment of internal solid tumors, new technological developments are needed that will enable treatment of these tumors in daily clinical practice. New electrodes through which electric pulses are delivered to target tissue need to be designed with the aim to access target tissue anywhere in the body. To increase the probability of complete tumor eradication, the electrodes have to be accurately positioned, first to provide an adequate extent of electroporation of all tumor cells and second not to damage critical healthy tissue or organs in its vicinity. This can be achieved by image guided insertion of electrodes that will enable accurate positioning of the electrodes in combination with patient-specific numerical treatment planning or using a predefined geometry of electrodes. In order to be able to use electrochemotherapy safely for treatment of internal tumors located in relative proximity of the heart (e.g., in case of liver metastases), the treatment must be performed without interfering with the heart’s electrical activity. We describe recent technological advances, which allow treatment of liver and bone metastases, soft tissue sarcomas, brain tumors, and colorectal and esophageal tumors. The first clinical experiences in these novel application areas of electrochemotherapy are also described.
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