Med Biol Eng Comput - Electrochemotherapy: technological advancements for efficient electroporation-based treatment of internal tumors.


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Electrochemotherapy, a combination of high voltage electric pulses and of an anticancer drug, has been demonstrated to be highly effective in treatment of cutaneous and subcutaneous tumors. Unique properties of electrochemotherapy (e.g., high specificity for targeting cancer cells, high degree of localization of treatment effect, capacity for preserving the innate immune response and the structure of the extracellular matrix) are facilitating its wide spread in the clinics. Due to high effectiveness of electrochemotherapy in treatment of cutaneous and subcutaneous tumors regardless of histological origin, there are now attempts to extend its use to treatment of internal tumors. To advance the applicability of electrochemotherapy to treatment of internal solid tumors, new technological developments are needed that will enable treatment of these tumors in daily clinical practice. New electrodes through which electric pulses are delivered to target tissue need to be designed with the aim to access target tissue anywhere in the body. To increase the probability of complete tumor eradication, the electrodes have to be accurately positioned, first to provide an adequate extent of electroporation of all tumor cells and second not to damage critical healthy tissue or organs in its vicinity. This can be achieved by image guided insertion of electrodes that will enable accurate positioning of the electrodes in combination with patient-specific numerical treatment planning or using a predefined geometry of electrodes. In order to be able to use electrochemotherapy safely for treatment of internal tumors located in relative proximity of the heart (e.g., in case of liver metastases), the treatment must be performed without interfering with the heart's electrical activity. We describe recent technological advances, which allow treatment of liver and bone metastases, soft tissue sarcomas, brain tumors, and colorectal and esophageal tumors. The first clinical experiences in these novel application areas of electrochemotherapy are also described.

Resumo Limpo

electrochemotherapi combin high voltag electr puls anticanc drug demonstr high effect treatment cutan subcutan tumor uniqu properti electrochemotherapi eg high specif target cancer cell high degre local treatment effect capac preserv innat immun respons structur extracellular matrix facilit wide spread clinic due high effect electrochemotherapi treatment cutan subcutan tumor regardless histolog origin now attempt extend use treatment intern tumor advanc applic electrochemotherapi treatment intern solid tumor new technolog develop need will enabl treatment tumor daili clinic practic new electrod electr puls deliv target tissu need design aim access target tissu anywher bodi increas probabl complet tumor erad electrod accur posit first provid adequ extent electropor tumor cell second damag critic healthi tissu organ vicin can achiev imag guid insert electrod will enabl accur posit electrod combin patientspecif numer treatment plan use predefin geometri electrod order abl use electrochemotherapi safe treatment intern tumor locat relat proxim heart eg case liver metastas treatment must perform without interf heart electr activ describ recent technolog advanc allow treatment liver bone metastas soft tissu sarcoma brain tumor colorect esophag tumor first clinic experi novel applic area electrochemotherapi also describ

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