Probability of Tumor Lysis Syndrome in Electrochemotherapy of Large Solid Tumors: A Pilot Study Publisher



A Larijani AMIRADEL ; Sm Yazdanparast Seyed MOJTABA ; Fr Pouria Farshid ROSTAMI ; N Manoochehri NAVID ; M Bayat MAHDIS ; S Mansouri S ; N Sharghi NASIM ; S Mansouri SEPIDEH ; O Nabavian OMID ; F Memari FEREIDOON
Source: European Journal of Cancer Care Published:2025

Abstract

Background: Electrochemotherapy (ECT) has emerged as a promising targeted therapy to enhance drug delivery and minimize systemic side effects in cancer patients. However, concerns about tumor lysis syndrome (TLS) and other complications persist, particularly in patients with large solid tumors. Methods: This study evaluated the clinical outcomes, adverse effects including TLS occurrence and survival rates of ECT in 15 patients with advanced or metastatic solid tumors at Emam Khomeini Hospital from November 2023 to November 2024. Results: The study included 15 patients (60% female, 40% male) with a median age of 55 years. Tumor types included sarcoma (20%), squamous cell carcinoma (40%), invasive ductal carcinoma (33%), and angiosarcoma (7%). Eleven patients achieved complete remission, while four showed partial response. No cases of stable disease or progression were observed. The mean tumor area reduction was 90%, with an 84% overall survival rate for 3 months. No patients developed TLS, and adverse effects were minimal, with only four patients experiencing transient acidosis post-ECT. There was no significant difference between disease-free survival (DFS) of various tumor types, while recurrent tumors had better DFS in comparison with nonrecurrent ones. Conclusion: This study confirms ECT as an effective and safe treatment for large solid tumors, with significant tumor regression and no serious complications such as TLS. These findings support ECT as a viable alternative method for patients with primary tumors, inoperable or treatment-resistant ones. © 2025 Elsevier B.V., All rights reserved.