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Open AccessJournal ArticleDOI

Intraoperative electrochemotherapy of colorectal liver metastases: A prospective phase II study.

TLDR
Electrochemotherapy has proven to be safe and effective in the treatment of colorectal liver metastases, with a durable response, and provides local tumor control that enables patients with unresectable metastases to receive further treatments.
Abstract
Background and objectives A previous pilot study proved the feasibility, safety and efficacy of electrochemotherapy in the treatment of colorectal liver metastases. The aim of this study was to evaluate long-term effectiveness and safety of electrochemotherapy in the treatment of unresectable colorectal liver metastases. Patients and methods In this prospective phase II study, patients with metachronous colorectal liver metastases were included. In all patients, at least one metastasis was unresectable due to its central location or a too-small future remnant liver volume. Patients were treated by electrochemotherapy using intravenously administered bleomycin during open surgery. Treated were 84 metastases in 39 patients. Local tumor control, progression-free survival and overall survival were evaluated. Results The objective response was 75% (63% CR, 12% PR). The median duration of the response was 20.8 months for metastases in CR and 9.8 months for metastases in PR. The therapy was significantly more effective for metastases smaller than 3 cm in diameter than for larger ones. There was no difference in response according to the metastatic location, i.e., metastases in central vs. peripheral locations. Progression-free survival was better in patients who responded well to electrochemotherapy compared to those metastases that had a partial response or progressive disease. However, there was no difference in overall survival, with a median of 29.0 months. Conclusions Electrochemotherapy has proven to be safe and effective in the treatment of colorectal liver metastases, with a durable response. It provides local tumor control that enables patients with unresectable metastases to receive further treatments.

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Biological factors of the tumour response to electrochemotherapy: Review of the evidence and a research roadmap.

TL;DR: In this paper, the authors provide a summary of the currently used guiding clinical factors and delineates a research roadmap for future studies to identify putative biomarkers of response to ECT.
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A Systematic Review about Imaging and Histopathological Findings for Detecting and Evaluating Electroporation Based Treatments Response.

TL;DR: A general overview of the main imaging and histopathological findings of electroporation-based treatments compared to thermal approach, such as radiofrequency ablation (RFA), in deep-seated cancers with a particular attention to pancreatic and liver cancer was provided in this paper.
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Electrochemotherapy of Deep-Seated Tumors: State of Art and Perspectives as Possible "EPR Effect Enhancer" to Improve Cancer Nanomedicine Efficacy.

TL;DR: In this paper, the authors proposed the use of electrochemotherapy as an EPR enhancer of a target tumor, combined with the intratumoral administration of drug-loaded nanoparticles.
References
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Journal ArticleDOI

Modified RECIST (mRECIST) Assessment for Hepatocellular Carcinoma

TL;DR: A group of experts developed a set of guidelines aimed at providing a common framework for the design of clinical trials in HCC and adapted the concept of viable tumor-tumoral tissue showing uptake in arterial phase of contrast-enhanced radiologic imaging techniques-to formally amend RECIST, referred to herein as the modified RECIST assessment (mRECIST).
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Colorectal cancer liver metastases – a population-based study on incidence, management and survival

TL;DR: The worse survival in liver metastatic right-sided Colon cancer could possibly be explained by the higher number of metastases, as well as more extensive segmental involvement compared with left-sided colon and rectal cancer, even though the latter had a higher incidence of liver metastases.
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Irreversible electroporation for nonthermal tumor ablation in the clinical setting: a systematic review of safety and efficacy.

TL;DR: Overall, the future of IRE for difficult-to-reach tumors appears promising, and in cases where other techniques are unsuitable, IRE is a promising modality for the ablation of tumors near bile ducts and blood vessels.
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Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures.

TL;DR: This study aims to evaluate the safety and efficacy of IRE for hepatic tumors in the clinical setting with a double-blind, placebo-controlled trial.
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Sequential finite element model of tissue electropermeabilization

TL;DR: A sequential finite element model of E distribution in tissue which considers local changes in tissue conductivity due to permeabilization and can predict the permeabilized volume of tissue, when exposed to electrical treatment.
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