Background: Keratinocyte carcinomas, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), presents a growing concern. Electrochemotherapy (ECT), an emerging treatment modality, combines chemotherapy and electroporation to enhance drug delivery into cells. However, reviews evaluating ECT in keratinocyte carcinomas are lacking. Objectives: This study reviews the efficacy and toxicity of ECT in the treatment and palliation of keratinocyte carcinomas. Methods: A systematic search was conducted across PubMed, Cochrane, Embase, and Scopus databases. Patient, tumor, and treatment characteristics, tumor response, long-term disease outcomes, and toxicity data were extracted. Quality of studies was assessed using validated tools. Primary endpoints included tumor response; secondary endpoints included long-term disease outcomes and toxicity. Results: Twenty-one studies were included. Complete response (CR) rates ranged from 50 to 100% and from 10 to 100% for BCC and SCC, respectively. OS rates ranged from 95 (14 months) to 100 (1 year) % and from 64 (1 year) to 85.1 (8.6 months) % for BCC and SCC, respectively. One-year local disease-free survival (LDFS) rates were 89% and 87% for BCC and SCC, respectively. For BCC, local progression-free survival (LPFS) rates were 96% (1 year), 90% (2 year), and 70% (5 year). For SCC, 1-year LPFS rates were 80% on a per-patient basis and 49% on a per-lesion basis. Conclusions: ECT is effective and tolerable in the treatment and palliation of keratinocyte carcinomas. Future studies should focus on improving reporting quality, optimizing treatment protocols, and investigating long-term outcomes.
背景：角化细胞癌，包括基底细胞癌（BCC）和鳞状细胞癌（SCC），日益受到关注。电化学疗法（ECT）作为一种新兴治疗方式，结合化疗与电穿孔技术以增强药物向细胞内的递送。然而，目前缺乏评估ECT在角化细胞癌中应用效果的系统综述。目的：本研究旨在综述ECT在角化细胞癌治疗及姑息治疗中的疗效与毒性。方法：系统检索PubMed、Cochrane、Embase和Scopus数据库。提取患者特征、肿瘤特征、治疗参数、肿瘤反应、长期疾病结局及毒性数据。采用标准化工具评估研究质量。主要终点为肿瘤反应；次要终点包括长期疾病结局及毒性。结果：共纳入21项研究。BCC和SCC的完全缓解率分别为50%-100%和10%-100%。BCC的总生存率分别为95%（14个月）至100%（1年），SCC为64%（1年）至85.1%（8.6个月）。BCC和SCC的1年局部无病生存率分别为89%和87%。BCC的1年、2年和5年局部无进展生存率分别为96%、90%和70%。SCC的1年局部无进展生存率按患者计为80%，按病灶计为49%。结论：ECT在角化细胞癌的治疗及姑息治疗中具有良好疗效与耐受性。未来研究应聚焦于提升报告质量、优化治疗方案并探索长期结局。
Electrochemotherapy in the Management of Keratinocyte Carcinomas: A Systematic Review
肿瘤(癌症)患者之家