Background: Relapsed unresectable triple-negative breast cancer is a demanding disease with only a few treatment options. Especially for patients with unresectable tumor masses, a treatment that offers rapid tumor shrinkage is needed. If patients are exhausted from several treatment lines, systemic side effects have to be avoided. Reversible electroporation has shown to be effective for breast cancer if combined with systemic bleomycin and/or cisplatin. To enhance the local effect and reduce the systemic side effects, we combined reversible electroporation with regional chemotherapy. Materials and Methods: Patients with advanced metastasized and relapsed breast cancer received regional chemotherapy via intra-arterial infusion and isolated thoracic perfusion combined with percutanous reversible electroporation. Circulating tumor cells (CETCs/CTCs) were counted before and 24 h after the treatment. Tumor response was evaluated by CT (computer tomography) control. Results: A total of 21 treatments were conducted for 14 patients who had a mean tumor size of 7.6 cm (standard deviation 3.3 cm). Higher local drug levels are present with arterial infusion compared to venous infusion and result in enhanced response rates. Circulating tumor cells decreased or stayed stable for 24 h after the treatment for 11 and 8 cases, respectively. An increase was observed in two cases. A total of 13 patients showed a clinical response with tumor shrinkage that led to resectability. One patient did not respond to the treatment regimen. Conclusions: The combination of reversible electroporation with intra-arterial chemotherapy is feasible and results in a good clinical response with neglectable side effects. The treatment is repeatable and can lead to resectability.
背景：复发性不可切除三阴性乳腺癌是一种难治性疾病，治疗选择有限。尤其对于存在不可切除肿瘤肿块的患者，亟需能够快速缩小肿瘤的治疗方案。若患者已接受多线治疗且身体状态衰竭，则需避免全身性副作用。既往研究表明，可逆电穿孔联合全身性博来霉素和/或顺铂治疗对乳腺癌有效。为增强局部疗效并降低全身副作用，本研究将可逆电穿孔与区域化疗相结合。 材料与方法：对晚期转移性复发性乳腺癌患者实施经动脉灌注及隔离性胸腔灌注的区域化疗，并联合经皮可逆电穿孔治疗。在治疗前及治疗后24小时分别计数循环肿瘤细胞。通过计算机断层扫描评估肿瘤反应。 结果：共对14例患者进行21次治疗，患者平均肿瘤大小为7.6厘米（标准差3.3厘米）。与静脉输注相比，动脉灌注可实现更高的局部药物浓度，从而提升治疗反应率。治疗后24小时，11例患者循环肿瘤细胞数量下降，8例保持稳定，2例出现升高。13例患者出现临床反应，肿瘤缩小达到可切除标准，1例患者对治疗方案无反应。 结论：可逆电穿孔联合动脉内化疗的方案具有可行性，能产生良好的临床疗效且副作用可忽略。该治疗可重复实施，并能促使肿瘤达到可切除状态。
肿瘤(癌症)患者之家