Efficient palliation of haemorrhaging malignant melanoma skin metastases by electrochemotherapy

Electric pulses can cause transient permeabilization of cell membranes (ele ctroporation) and this can be utilized to increase the uptake of chemothera py (electrochemotherapy). Preclinical studies have shown that in vivo elect roporation causes transient shut down of blood flow both in normal and, in particular, malignant tissues. We report the successful palliation of a mal ignant melanoma patient with bleeding skin metastases using electrochemothe rapy. In an on-going study of combined electrochemotherapy and low dose int erleukin-2, one patient with bleeding skin metastases was included. Nine sk in metastases, of which seven were ulcerated, were treated. After Intratumo ral bleomycin injection, needle electrodes with two arrays 4 mm apart were inserted into the tumours. Eight square wave electric pulses each 99 mus in duration and with an applied voltage to electrode distance ratio of 1.2 kV /cm were administered. In all the treated lesions, bleeding immediately sto pped on administration of the electric pulses and did not recur. The treate d metastases developed crusts and the lesions heated in a matter of weeks. Treatments were given under local anaesthesis, lasted a few minutes, and pa tient discomfort was brief and modest. In conclusion, we propose that elect rochemotherapy should be considered for the palliation of haemorrhaging met astases as it is an efficient, tolerable, brief, outpatient, once-only trea tment. (C) 2000 Lippincott Williams & Wilkins.