Long term efficacy of reduced dose bleomycin electrochemotherapy in elderly patients

Abstract

Background. Electrochemotherapy (ECT) is a local cancer treatment based on electroporation where the electric field is used to enhance cell membrane permeability and thereby facilitating the transition of chemotherapeutic agents into the cell. For the treatment of non-melanoma skin cancer, a standard dosage of 15,000 IU/m² bleomycin (BLM) is used. The aim of our study was to evaluate the long-term results of ECT with a reduced dose of 10.000 IU/m² BLM.

Patients and methods. Twenty-eight patients older than 65 years, with a total of 52 non-melanoma skin lesions were included in the study. Twelve patients (24 lesions) in the experimental group received a reduced dose of BLM, 16 patients (28 lesions) were treated with a standard dose of BLM.

Results. No statistically significant difference was observed between both groups. In the experimental group, tumors recurred in 39.0% of treated lesions in a median follow-up time of 28 months. In the control group, the recurrence rate of treated lesions was 15.4% in a median follow-up time of 40 months.

Conclusions. ECT with a reduced dose of BLM is a feasible treatment option for elderly patients with efficacy comparable to standard dose treatment and should be considered as a treatment modality in advanced aged patients with comorbidities, where overall life expectancy is poor.