Combination of Electrochemotherapy with Radiotherapy: A Comprehensive, Systematic, PRISMA-Compliant Review of Efficacy and Potential Radiosensitizing Effects in Tumor Control

Curr Oncol. 2023 Nov 13;30(11):9895-9905. doi: 10.3390/curroncol30110719.

Abstract

Radiotherapy (RT) and electrochemotherapy (ECT) are established local treatments for cancer. While effective, both therapies have limitations, especially in treating bulky and poorly oxygenated tumors. ECT has emerged as a promising palliative treatment, raising interest in exploring its combination with RT to enhance tumor response. However, the potential benefits and challenges of combining these treatments remain unclear. A systematic review was conducted following PRISMA guidelines. PubMed, Scopus, and Cochrane libraries were searched. Studies were screened and selected based on predefined inclusion and exclusion criteria. Ten studies were included, comprising in vitro and in vivo experiments. Different tumor types were treated with ECT alone or in combination with RT. ECT plus RT demonstrated superior tumor response compared to that under single therapies or other combinations, regardless of the cytotoxic agent and RT dose. However, no study demonstrated a clear superadditive effect in cell survival curves, suggesting inconclusive evidence of specific ECT-induced radiosensitization. Toxicity data were limited. In conclusion, the combination of ECT and RT consistently improved tumor response compared to that with individual therapies, supporting the potential benefit of their combination. However, evidence for a specific ECT-induced radiosensitization effect is currently lacking. Additional investigations are necessary to elucidate the potential benefits of this combination therapy.

Keywords: electrochemotherapy; electroporation; radiosensitivity; radiotherapy; systematic review.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Electrochemotherapy*
  • Humans
  • Neoplasms* / drug therapy
  • Neoplasms* / radiotherapy
  • Palliative Care
  • Radiation-Sensitizing Agents* / pharmacology
  • Radiation-Sensitizing Agents* / therapeutic use

Substances

  • Radiation-Sensitizing Agents
  • Antineoplastic Agents

Grants and funding

This research received no external funding.