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Effectiveness of electrochemotherapy after IFN-α adjuvant therapy of melanoma patients

Andrejc Hribernik
Andrejc Hribernik
, 
Maja Cemazar
Maja Cemazar
, 
Gregor Sersa
Gregor Sersa
, 
Maša Bosnjak
Maša Bosnjak
 and 
Marko Snoj
Marko Snoj
   | Feb 16, 2016
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Article Category: Research Article
Published Online: Feb 16, 2016
Page range: 21 - 27
Received: Oct 20, 2015
Accepted: Nov 30, 2015
DOI: https://doi.org/10.1515/raon-2015-0048
Keywords
© 2016 Radiol Oncol
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1.

Melanoma lesions in patient 1 (A) and patient 5 (B) before and 6 weeks after electrochemotherapy (ECT). Both metastases in patient 1 responded completely, while in patient 5 although the crust is seen on the images there was nodule under it and response was evaluated as partial response.
Melanoma lesions in patient 1 (A) and patient 5 (B) before and 6 weeks after electrochemotherapy (ECT). Both metastases in patient 1 responded completely, while in patient 5 although the crust is seen on the images there was nodule under it and response was evaluated as partial response.

Treatment regime

Patient 1Patient 2Patient 3Patient 4Patient 5
INF-a dose6 million IU 3 × weekly (s.c.)3 million IU 3 × weekly (s.c.)35 milion IU 20 × (i.v.) in 8 weeks/15 million IU 3× weekly (s.c.) for 13 weeks/ 10 milion IU 3 × weekly (s.c.) for 13 weeks

prematurelly terminated treatment due to ineffective treatment;

30 milion IU 20 × (i.v.) in 4 weeks followed by 15 million IU 3× weekly (s.c.) for 35 weeks followd by 10 milion IU 3 × weekly (s.c.) for 12 weeks30 milion IU 9 × (i.v.) in 2 weeks followed by 20 milion IU 11× (i.v.) in 3 weeks followed by 15 million IU 3× weekly (s.c.) for 13 weeks

intravenous dose (i.v. dose) was decreased to 20 million IU due to pathological liver tests - prematurelly terminated treatment due to side effects

INF-α treatment period2 years 9 months7 months8 months12 months4 months
Last date of INF-α treatmentMarch 2004August 1998July 2012January 2012June 2011
Disease free interval4 months5 years 6 months6 months3 months2 months
Surgically excised metastases

details on localization and number of excised metastates in paragraph Pacients’ caracteristics.

YesYesNoYesYes
Interval between INF-α and ECT treatment4 years 8 months12 years 11 months7 months6 months7 months
ECT treatmentNovember 2008July 2011February 2013July 2013January 2012
ECT drugCisplatinCisplatinBleomycinBleomycinBleomycin
Number of lesions2180235
Size of the nodules1.0 × 1.5 cm 1.5 × 1.5 cm3 × 3 cm0.3–1 cm0.1–0.8 cm0.7–1.5 cm
Effect after 4 weeksCRCR> 85% CRAll CR100% PR
LRD

after last record date at the Institute of Oncology Ljubljana patients were given only paliative care at their regional centers

 or date of death (D)		April 2010 (LRD)December 2014 (LRD)April 2014 (LRD)December 2013 (D)March 2013 (D)

Patients’ characteristics

Patient 1Patient 2Patient 3Patient 4Patient 5
GenderMaleMaleFemaleFemaleFemale
Birth year19581935193719531941
TNM

according to AJCC TNM Cancer Staging Manual 7th edition (2010)6; ECT = electrochemotherapy

T3aNOMOT2aNOMOT4bN1aMOT3aN1aMOT4bN1aMO
Patological stage

according to AJCC TNM Cancer Staging Manual 7th edition (2010)6; ECT = electrochemotherapy

Stage IIaStage IbStage IIIbStage IIIaStage IIIb
Breslow4 mm1.5 mm10 mm2.8 mm9.5 mm
Ulceration//10 mm/2.5 mm
Localisation of primary tumorRight lower legLeft footRight footRight lower legBack
Localisation of metastases treated with ECTRight lower legLeft foot (dorsum)Left lower legRight lower legBreast, left side
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