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un 22&#37; una respuesta parcial&#44; un 12&#37; una estabilizaci&#243;n de la enfermedad y un 3&#37; tuvo progresi&#243;n de la enfermedad&#46; Por tipo histol&#243;gico las mejores respuestas fueron en el SK &#40;RC 91&#37;&#41; con una respuesta global &#40;RG &#91;definida como RC m&#225;s respuesta parcial&#93;&#41; del 98&#37;&#44; seguido del CBC &#40;RC 85&#37;&#44; RG 96&#37;&#41;&#44; del melanoma &#40;RC 64&#37;&#44; RG 82&#37;&#41;&#44; de las met&#225;stasis cut&#225;neas del c&#225;ncer de mama &#40;RC 62&#37;&#44; RG 77&#37;&#41; y del carcinoma epidermoide cut&#225;neo &#40;RC 63&#37;&#44; RG 80&#37;&#41;&#46; Otros factores asociados con una mayor eficacia fueron el menor tama&#241;o tumoral &#40;RC 82&#37; en lesiones menores de 5<span class="elsevierStyleHsp" style=""></span>mm&#44; descendiendo a 35&#37; en mayores de 10<span class="elsevierStyleHsp" style=""></span>cm&#41; y la administraci&#243;n intravenosa &#40;respecto a intralesional&#41; en las lesiones mayores de 2<span class="elsevierStyleHsp" style=""></span>cm&#44; mientras que se observ&#243; una menor eficacia en tejidos previamente irradiados &#40;RC del 59&#37; frente a un 71&#37;&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As&#237;&#44; si en el SK unimos unas altas tasas de RC &#40;similares a las observadas en la literatura cient&#237;fica&#41; junto a la gran seguridad y tolerabilidad de esta t&#233;cnica&#44; hacen que sea muy interesante en aquellos pacientes con lesiones m&#250;ltiples de SK<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#44; al igual que para el tratamiento del CBC&#44; donde otras opciones han fallado o no sean posibles&#46; En el melanoma su principal papel actualmente est&#225; en el tratamiento de las met&#225;stasis cut&#225;neas sintom&#225;ticas &#40;RG 50-80&#37; seg&#250;n la serie consultada&#41;&#44; sin embargo&#44; dada su acci&#243;n&#44; provocando la muerte celular inmunog&#233;nica<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#44; se est&#225;n llevando a cabo estudios de asociaci&#243;n de EQT con agentes inmunomoduladores&#44; con el fin de comprobar su posible eficacia para el tratamiento sist&#233;mico del melanoma&#44; ampliando esta acci&#243;n inmune local para conseguir una acci&#243;n inmune antitumoral sist&#233;mica &#40;asociaci&#243;n ya demostrada en modelos murinos<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#41;&#46; Sin embargo&#44; hasta el momento solo disponemos de casos y series cortas publicadas de asociaci&#243;n de ECT con ipilumamab e inhibidores de PD-1 con resultados variables&#44; aunque prometedores&#44; en espera de los resultados de los estudios en curso&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Por todo ello la ECT se debe plantear dentro de las opciones terap&#233;uticas que ofrecer a nuestros pacientes&#44; dentro de una toma de decisiones multidisciplinar&#46;</p></span>"
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Foro de Residentes
FR- Electroquimioterapia para el tratamiento de tumores cutáneos primarios y secundarios
RF- Electrochemotherapy in the Treatment of Primary and Secondary Skin Tumors
D. Vega Díez
Corresponding author
david.vg10@gmail.com

Autor para correspondencia.
, A. Rodríguez-Villa Lario, L. Trasobares Marugán
Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
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versatilidad&#44; eficacia y tolerabilidad&#44; con escasos efectos adversos de importancia&#44; pudiendo ser usada en pacientes fr&#225;giles&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Recientemente Clover et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> han presentado los resultados del <span class="elsevierStyleItalic">Pan-European International Network for Sharing Practice in Electrochemotherapy&#46;</span> Aqu&#237; se recogen los resultados de 987 pacientes con diversas neoplasias cut&#225;neas tratados con EQT&#44; siendo el melanoma el tumor m&#225;s frecuentemente tratado &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>283&#44; 29&#37;&#41; seguido del CBC &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>298&#44; 30&#37;&#41;&#46; Del global de pacientes un 61&#37; tuvo una respuesta completa &#40;RC&#41;&#44; un 22&#37; una respuesta parcial&#44; un 12&#37; una estabilizaci&#243;n de la enfermedad y un 3&#37; tuvo progresi&#243;n de la enfermedad&#46; Por tipo histol&#243;gico las mejores respuestas fueron en el SK &#40;RC 91&#37;&#41; con una respuesta global &#40;RG &#91;definida como RC m&#225;s respuesta parcial&#93;&#41; del 98&#37;&#44; seguido del CBC &#40;RC 85&#37;&#44; RG 96&#37;&#41;&#44; del melanoma &#40;RC 64&#37;&#44; RG 82&#37;&#41;&#44; de las met&#225;stasis cut&#225;neas del c&#225;ncer de mama &#40;RC 62&#37;&#44; RG 77&#37;&#41; y del carcinoma epidermoide cut&#225;neo &#40;RC 63&#37;&#44; RG 80&#37;&#41;&#46; Otros factores asociados con una mayor eficacia fueron el menor tama&#241;o tumoral &#40;RC 82&#37; en lesiones menores de 5<span class="elsevierStyleHsp" style=""></span>mm&#44; descendiendo a 35&#37; en mayores de 10<span class="elsevierStyleHsp" style=""></span>cm&#41; y la administraci&#243;n intravenosa &#40;respecto a intralesional&#41; en las lesiones mayores de 2<span class="elsevierStyleHsp" style=""></span>cm&#44; mientras que se observ&#243; una menor eficacia en tejidos previamente irradiados &#40;RC del 59&#37; frente a un 71&#37;&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As&#237;&#44; si en el SK unimos unas altas tasas de RC &#40;similares a las observadas en la literatura cient&#237;fica&#41; junto a la gran seguridad y tolerabilidad de esta t&#233;cnica&#44; hacen que sea muy interesante en aquellos pacientes con lesiones m&#250;ltiples de SK<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#44; al igual que para el tratamiento del CBC&#44; donde otras opciones han fallado o no sean posibles&#46; En el melanoma su principal papel actualmente est&#225; en el tratamiento de las met&#225;stasis cut&#225;neas sintom&#225;ticas &#40;RG 50-80&#37; seg&#250;n la serie consultada&#41;&#44; sin embargo&#44; dada su acci&#243;n&#44; provocando la muerte celular inmunog&#233;nica<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#44; se est&#225;n llevando a cabo estudios de asociaci&#243;n de EQT con agentes inmunomoduladores&#44; con el fin de comprobar su posible eficacia para el tratamiento sist&#233;mico del melanoma&#44; ampliando esta acci&#243;n inmune local para conseguir una acci&#243;n inmune antitumoral sist&#233;mica &#40;asociaci&#243;n ya demostrada en modelos murinos<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#41;&#46; Sin embargo&#44; hasta el momento solo disponemos de casos y series cortas publicadas de asociaci&#243;n de ECT con ipilumamab e inhibidores de PD-1 con resultados variables&#44; aunque prometedores&#44; en espera de los resultados de los estudios en curso&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Por todo ello la ECT se debe plantear dentro de las opciones terap&#233;uticas que ofrecer a nuestros pacientes&#44; dentro de una toma de decisiones multidisciplinar&#46;</p></span>"
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Article information
ISSN: 00017310
Original language: Spanish
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Idiomas
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