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Palliative treatment with electrochemotherapy in recurrent or metastatic vaginal cancer
  1. Anna Myriam Perrone1,2,
  2. Martina Ferioli3,
  3. Andrea Galuppi2,3,
  4. Manuela Coe4,
  5. Francesca De Terlizzi5,
  6. Marco Tesei1,2,
  7. Giulia Dondi1,2,
  8. Alessandra De Palma6,
  9. Alessio G Morganti2,3 and
  10. Pierandrea De Iaco1,2
  1. 1 Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy
  2. 2 Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, Bologna, Italy
  3. 3 Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine, DIMES Univerisity of Bologna, Bologna, Italy
  4. 4 Department of Experimental, Diagnostic and Specialty Medicine, Unit of Radiology, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy
  5. 5 Scientific and Medical Department, IGEA S.p.A, Carpi (Mo), Italy
  6. 6 Forensic Medicine and Integrated Risk Management Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy
  1. Correspondence to Dr Anna Myriam Perrone, Azienda Ospedaliero-Universitaria di Bologna Policlinico SantOrsola-Malpighi, Bologna 40123, Italy; myriam.perrone{at}aosp.bo.it

Abstract

Objective Vaginal metastases are very rare events with a poor prognosis. To improve the quality of life, local treatments should be considered. The aim of this study was to evaluate the role of electrochemotherapy as palliative treatment in vaginal cancer not amenable to standard treatments due to poor performance status, previous treatments, or advanced disease.

Methods This is a prospective observational study on patients diagnosed with vaginal cancer and treated from January 2017 to December 2018 with palliative electrochemotherapy. We collected data on patients with vaginal cancer treated by electrochemotherapy with the aim of local control. Data regarding electrochemotherapy, hospital stay, adverse events, and patient outcomes were analyzed. Intravenous bleomycin was injected as a bolus in 2–3 min at a dose of 15 000 UI/m2 and electrical pulses started 8 min after chemotherapy. Electrochemotherapy response was defined according to the Response Evaluation Criteria in Solid Tumors.

Results Five patients with vaginal recurrence (two squamous, two melanomas, and one leiomyosarcoma) and one with vaginal metastasis from intestinal adenocarcinoma received one treatment and two patients were re-treated. Imaging reported nodal metastasis (inguinal or pelvic) in two patients, distant metastases in two, and both node and distant metastasis in two patients, respectively. Response Evaluation Criteria in Solid Tumors showed a complete response in one patient, partial response in three patients, stable disease in one patient, and progressive disease in one patient, with an overall response rate of 67% and a clinical benefit rate (complete response, partial response, stable disease) of 83%. Two patients were re-treated and had a new response (partial response and stable disease, respectively). At last follow-up, two patients had died of the disease, two were alive with stable disease, one was alive with progressive disease, and one was alive without disease. Median post-electrochemotherapy overall survival was 12.9 months (range 1.6–26.9) and 1-year overall survival was 66.7%.

Conclusions This preliminary experience showed a tumor response or stabilization in 83% of patients requiring palliative management for vaginal cancer. Further studies are needed to evaluate treatment outcome in larger and prospective series.

  • palliative care
  • vaginal neoplasms
  • genital neoplasms, female
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Footnotes

  • AGM and PDI contributed equally.

  • Correction notice Since the online publication of this article, the author name 'Alessio G Morganti' was updated to include the middle initial.

  • Contributors Conceptualization: AMP. Data curation: MT, GD. ECT procedures: MF, AG. Formal analysis: FDT. Clinical imaging: MC. Supervision: ADP, AM, PDI. Same position AM, PDI.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MF has received a grant from IGEA and FDT is an employee of IGEA.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data will be available upon request.

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