ELECTROCHEMOTHERAPY FOR MASTOCYTOMAS

Previous reports
Tozon N, Sersa G and Cemazar M, in Anticancer Res. 2001 Jul-Aug;21(4A):2483-8. "Electrochemotherapy: potentiation of local antitumour effectiveness of cisplatin in dogs and cats" reported 2 cases treated. This work was also reported at ESVONC Spring 2006. Anticancer Res. 2006 Nov-Dec;26(6B):4585-9. Spugnini EP, Vincenzi B, Baldi F, Citro G, Baldi A., Adjuvant electrochemotherapy for the treatment of incompletely resected canine mast cell tumors. "Twenty-eight privately-owned dogs with incompletely removed MCT were treated with intralesional bleomycin (1.5 IU/cm2) followed by the application of trains of biphasic pulses (8 pulses, 1300 V/cm, 50 + 50 micros duration, 1 Hz frequency). RESULTS: The overall response rate was 85% with a mean estimated time to recurrence of 52.76 +/- 6.5 months (range: 39.99 to 65.54 months, 95% CI). At the time of writing this report, the median survival time was not reached. Three dogs died of metastatic disease that they developed at the same time of local recurrence, one developed multiple cutaneous nodules at different locations and one with recurrence was retreated and is currently disease-free after 22 months. No major local or systemic toxicities were noted for the duration of the study. CONCLUSION: ECT is a safe and effective therapy for incompletely excised MCTs in companion animals. Its ease of administration, lack of toxicities and low cost make it an attractive alternative to standard treatments and warrants further investigation."

Evidence of antitumour effects of ECT in patients with macroscopic mast cell tumours
Case 1: 6 year old male Boxer with small papilloma-like lesion on medial R elbow checked with FNAB (treated at the same time as adjuvant treatment of operation site on carpus - see below): given Bleomycin i/v. Single treatment. 2 weeks post ECT: complete response. No recurrence at 862 days. No photographs. Case 2: 7 year old female Weimeraner with 3 c3mm nodules, 2 on ears and one on abdomen all diagnosed with cut abraded surface impression smears (treated at the same time as adjuvant treatment of operation site on anal ring- see below): given i/v Bleomycin and single treatment. Complete response at 6 weeks, no recurrence at 162 days. Pre-treatment

Post-treatment

Case 3: 8 year old male Staffs Bull terrier with FNAB diagnosed ill-defined MCT on point of elbow. Home VS reluctant to operate. Single treatment i/v Bleomycin. Partial response at 6 weeks but still +ve mast cells at centre of site. Minimal surgery by home VS. Lab reported tumour at deep margin.

No further treatment. Disease free at 407 days. Showing treatment area

6 weeks post-treatment

Case 4: 11 year old male Border Collie with ill-defined MCT within right upper lip diagnosed on FNAB. 2 Treatments with i/v Bleomycin 2 weeks apart. Treated area immediately after treatment.

Treated area 2 weeks later before second treatment.

Treated area 4 weeks later 2 weeks after second treatment.

Treated area 10 weeks after second treatment with healing complete. Regional LNs still -ve. Disease free at 84 days.

Case 5: 4 year old male Boxer with FNAB diagnosed MCT on dorsum of paw.Single treatment with intralesional Bleomycin and ECT. Pre-treatment

After 16 days, massive necrosis

At day 56, good healing

After 4 months: disease free at 125 days

Case 6: 6 year old JRT male with an ill-defined intermediate grade MCT partially removed from lateral hock but significant macroscopic tumour remaining medial hock. I/v and local infiltration combined for first treatmen. Immediately after initial treatment

Before second treatment 48 days later

Before second treatment 48 days later

Impression smear from 'granulating' area day 48

Retreated with i/v Bleomycin. 31 days after second treatment (day 79)

31 days after second treatment (day 79)

Adjuvant therapy to sites of incomplete resection

Case 1: 6 year old male Boxer, intermediate grade MCT removed from carpus. Tumour at margins on hittopathology. Wound dehiscence. Single treatment with i/v Bleomycin. Before ECT treatment

14 days latert

Day 49

Day 77 (disease free at day 862)

Case 2: 7 year old female Weimeraner with incompletely removed intermediate grade MCT left side of anal ring. Single treatment with i/v Bleomycin. Before ECT treatment

Day 9

Day 35

Disease free at day 162

Case 7: 8 year old Sheltie X male had intermediate grade MCT removed from left ischial region. Histopathology showed tumour at margins. Single treatment with i/v Bleomycin. Before ECT treatment

Day 19

Day 50

Disease free at day 369

Case 8: 10 year old male Xbred. Small MCT confirmed by FNAB left thorax. On preop clipping, further skin nodule found: FNAB showed MCT. Further clipping showed further nodule also MCT. Histopathology showed scattered islands of MCT with inter-island distances less than clear margins. Single treatment of 1.5 cm margin with i/v Bleomycin. Pre-op showing distribution of skin lesions

Op scar at day 24 pre-ECT treatment

7 days after ECT

14 days post-ECT: dog is disease free at day 69 from ECT

Case 9: 11 year old FN Xbred owned by VS with intermediate grade MCT at left ischial region infiltrating fat and ill-defined. Single ECT with i/v Bleomycin. No photos available. Disease free (in local area but possible de novo MCT stifle) day 489. Case 10: 6 year old male Labrador with intermediate grade MCT ventral thorax. Initial surgery showed tumour at margins. Follow-up surgery 'margins may have been achieved' but owners and VS keen for further treatment. Single treatment with i/v Bleomycin. Op scar before ECT treatment

case 11: 9 year old female Staff B T with intermediate grade MCT dorsum RH paw, tumour at margins after surgery. Single ECT with i/v Bleomycin. Resutured opsite after ECT

Marked necrosis at day 29 suggesting significant tumour residue after surgery

Granulating at day 43