International network for sharing practices on electrochemotherapy (InspECT): An integrative patients treatment consortium

Abstract

In this chapter we will present the International Network for Sharing Practices on Electrochemotherapy group, founded to answer the need of discussing issues and share experience on the use of the procedure, its history, and the objective for what it was established. Furthermore, on 2008 the online InspECT database was created as a tool for the Network to record data regarding clinical general examination of patients, measurement of tumor size to be treated, photographic documentation, type of anaesthesia, data on electrochemotherapy procedure, toxicity, side effects, pain, and quality of life. The amount of information stored is recorded to produce collaborative publications since all the data are entered according to the same parameters and continuously monitored according to good clinical procedures. Thanks to the collaborative work between the members of the Network it was possible to realize the publication of papers focused on specific electrochemotherapy issues. The first of them was about the management of cutaneous metastases from various solid tumors and allowed to state that electrochemotherapy offers a minimally invasive local treatment, provides local disease symptoms control, and improves patient's quality of life at the cost of only minor side effects. The second work published with the aim to evaluate which patients' category could be at risk for pain associated with electrochemotherapy identified factors related with an higher risk of postprocedural pain as diagnosis of breast cancer, treatment of preirradiated areas, largest diameter, and repetitive treatments demonstrating, however, that pain levels and pain medication overall decrease after the procedure. Finally, Bertino and Colleagues focused their attention on melanoma and nonmelanoma skin cancers of the head and neck treated with bleomycin electrochemotherapy. Electrochemotherapy resulted an effective treatment option for skin tumors of this specific area and in particular for basal cell carcinoma. The response rate in small, primary, and treatment-naive tumors is high and the functional, anatomical, and aesthetic preservation of the HN structures can be excellent at cost of welltolerated side effects.