Electrochemotherapy for the palliative management of cutaneous metastases: A systematic review and meta-analysis.

Electrochemotherapy Meta-analysis Palliative care Skin neoplasms Systematic review Treatment outcome

Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
Dec 2019
Historique:
received: 26 04 2019
revised: 21 06 2019
accepted: 02 07 2019
pubmed: 10 7 2019
medline: 19 6 2020
entrez: 10 7 2019
Statut: ppublish

Résumé

Electrochemotherapy combines electroporation in conjunction with chemotherapeutic agents and is used to treat tumours in many localisations, including cutaneous metastases. The symptoms associated with cutaneous malignant wounds can be distressing for patients and their management is a challenge in healthcare. The purpose of this systematic review was to investigate the effectiveness of electrochemotherapy in the context of palliative care. All aspects of the systematic review were followed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The following databases were searched for English-language reviews; Medline, Embase, CINAHL, British Nursing Index and the Cochrane Library. The search was conducted between the publication of Standard Operating Procedures in 2006 and the third week of October 2017. Studies involving oral cancers and studies with fewer than 10 patients were excluded. The selected studies were assessed for risk of bias and sub-group data were synthesised in a random-effects meta-analysis. From 425 studies, 29 studies were included involving 1503 patients, the pooled results were 46.6% for complete response and 82.2% for objective response according to the Response Evaluation Criteria in Solid Tumours. The meta-analysis indicated that small tumours were over twice as likely (2.25) to have a complete response than large. Electrochemotherapy is an effective, repeatable and minimally invasive intervention within the palliative population that can reduce symptom burden. This review is an update of previous systematic reviews by Mali et al. [1,2] and highlights the need for tailored treatment depending on each individual case.

Sections du résumé

BACKGROUND BACKGROUND
Electrochemotherapy combines electroporation in conjunction with chemotherapeutic agents and is used to treat tumours in many localisations, including cutaneous metastases. The symptoms associated with cutaneous malignant wounds can be distressing for patients and their management is a challenge in healthcare.
AIM OBJECTIVE
The purpose of this systematic review was to investigate the effectiveness of electrochemotherapy in the context of palliative care.
DESIGN METHODS
All aspects of the systematic review were followed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
DATA SOURCES METHODS
The following databases were searched for English-language reviews; Medline, Embase, CINAHL, British Nursing Index and the Cochrane Library. The search was conducted between the publication of Standard Operating Procedures in 2006 and the third week of October 2017. Studies involving oral cancers and studies with fewer than 10 patients were excluded. The selected studies were assessed for risk of bias and sub-group data were synthesised in a random-effects meta-analysis.
RESULTS RESULTS
From 425 studies, 29 studies were included involving 1503 patients, the pooled results were 46.6% for complete response and 82.2% for objective response according to the Response Evaluation Criteria in Solid Tumours. The meta-analysis indicated that small tumours were over twice as likely (2.25) to have a complete response than large.
CONCLUSIONS CONCLUSIONS
Electrochemotherapy is an effective, repeatable and minimally invasive intervention within the palliative population that can reduce symptom burden. This review is an update of previous systematic reviews by Mali et al. [1,2] and highlights the need for tailored treatment depending on each individual case.

Identifiants

pubmed: 31285093
pii: S0748-7983(19)30540-2
doi: 10.1016/j.ejso.2019.07.003
pii:
doi:

Substances chimiques

Antineoplastic Agents 0

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2257-2267

Commentaires et corrections

Type : CommentIn

Informations de copyright

Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.

Auteurs

Josephine Morley (J)

North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK. Electronic address: josephine.morley@nbt.nhs.uk.

Patricia Grocott (P)

King's College London, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, UK.

Edward Purssell (E)

School of Health Sciences City, University of London, UK.

Trevor Murrells (T)

King's College London, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, UK.

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Classifications MeSH