ECT and MCT

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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 re-

treated 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 forincompletely 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


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Post-treatment


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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.


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No further treatment. Disease free at 407 days.

Showing treatment area

6 weeks post-treatment


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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.


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Treated area 2 weeks later before second treatment.

Treated area 4 weeks later 2 weeks after second treatment.


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

free at 84 days.


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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


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At day 56, good healing


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After 4 months: disease free at 125 days


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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


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Before second treatment 48 days later


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Before second treatment 48 days later


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Impression smear from 'granulating' area day 48


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Retreated with i/v Bleomycin.

31 days after second treatment (day 79)


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31 days after second treatment (day 79)


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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


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14 days latert


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Day 49


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Day 77 (disease free at day 862)


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Case 2: 7 year old female Weimeraner with incompletely removed intermediate grade MCT left

side of anal ring. Single treatment with i/v Bleomycin.



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Day 9


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Day 35


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Disease free at day 162


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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.



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Day 19


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Day 50


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Disease free at day 369


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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


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Op scar at day 24 pre-ECT treatment

7 days after ECT


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


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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


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Marked necrosis at day 29 suggesting significant tumour residue after surgery


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Granulating at day 43


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Documents

ECT and MCT