Book of abstract 2008

Electrochemotherapy of cutaneous metastases of mammary carcinoma in
the mammary region after radical radiotherapy
Snežna Paulin Košir, Maja Čemažar, Gregor Serša
Institute of Oncology Ljubljana, Zaloška 2, SI-1000 Ljubljana, Slovenia
Electrochemotherapy has proved its clinical effectiveness in treatment of various
malignancies, including cutaneous recurrent mammary carcinoma. Furthermore, its clinical
benefit was also demonstrated for tumor nodules that regrew in pre-treated areas, after
surgery or radiotherapy. In mammary carcinoma patients, local recurrence in mammary
region poses a specific problem, especially after radical irradiation. Multiple cutaneous
nodules are usually dispersed, and not amenable to surgical resection. Furthermore, they
are often exulcerated, and additional radiotherapy is not possible because tissue tolerance
would be exceeded due to previous radical irradiation.
Among the electrochemotherapy treated patients at the Institute of Oncology Ljubljana,
were also two patients with multiple cutaneous tumor nodules of mammary carcinoma
in mammary region. The patients were previously treated by surgery and radiotherapy.
Further treatment options were exhausted, and they agreed for electrochemotherapy.
Electrochemotherapy was performed on 10 tumor nodules; their size ranging form 1 to
8 cm in diameter. Electrochemotherapy was performed in two consecutive sessions using
intratumoral injection of cisplatin, and application of electric pulses to the tumor nodules
using plate electrodes. The treatment was performed in local anesthesia, in ambulatory
way. The same day the patients were released home without any side effects.
After two weeks the treated nodules were in partial response. The scab was formed and in
the next 8 weeks in 92% treated nodules complete response was observed. Loco regional
disease after electrochemotherapy did not pose any problem to these patients. Up to two
years after the treatment there was no sign of local progression of the disease. However, the
disease progressed in visceral organs.
The described two cases demonstrate treatment effectiveness of electrochemotherapy
in patients with recurrent disease after radical radiotherapy. In such patients it is of vast
importance to have another line of treatment, because the nodules are usually exulcerated
and mutilating and there are no other treatment options.
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References:
1. Reberšek M, Čufer T, Čemažar M, Kranjc S, Serša G. Electrochemotherapy with cisplatin of cutaneous
tumor lesions in breast cancer. Anti-Cancer Drugs 2004; 15: 593-7.
2. Whelan MC, Larkin JO, Collins CG, Cashman J, Breathnach O, Soden D, O’Sullivan GC. Effective
treatment of an extensive recurrent breast cancer which was refractory to multimodal therapy by multiple
applications of electrochemotherapy. Eur J Cancer Suppl 2006; 4: 32-4.
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