Please cite this article in press as: Campana LG, et al. Electrochemotherapy in non-melanoma head and neck cancers: a retrospective analysis of the treated cases. Br J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.bjoms.2014.08.004 ARTICLE IN PRESS YBJOM-4324; No. of Pages 8 British Journal of Oral and Maxillofacial Surgery xxx (2014) xxx–xxx Available online at www.sciencedirect.com Electrochemotherapy in non-melanoma head and neck cancers: a retrospective analysis of the treated cases Luca Giovanni Campana a,∗ , Barbara Mali b , Gregor Sersa c , Sara Valpione a , Carlo A. Giorgi a , Primoz Strojan c , Damijan Miklavcic b , Carlo R. Rossi d a Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy b University of Ljubljana, Faculty of Electrical Engineering, Department of Biomedical Engineering, Slovenia c Institute of Oncology Ljubljana, Slovenia d Sarcoma and Melanoma Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy Accepted 12 August 2014 Abstract Electrochemotherapy increases the permeability of tumours to drugs by electric voltages applied locally. Its value in tumours of the head and neck is unknown. We retrospectively reviewed a 2-centre database, and found 39 patients with squamous cell carcinoma (SCC) of the oral cavity or oropharynx (n=12) or non-melanoma skin tumours (n=27) who had been treated with bleomycin electrochemotherapy with needle electrodes. A further 3 patients were given cisplatin electrochemotherapy (n=2), or bleomycin electrochemotherapy by plate electrodes (n=1). Local toxicity was mild. The complete response rate was 38% and was associated with whether the tumour was primary or recurrent (p<0.001), its size (p=0.02), and the route by which the drug was given (p=0.02). We did not study enough patients with basal cell carcinomas to say whether the response was significantly better or not (p=0.07). Skin tumours and SCC of the oral cavity or oropharynx showed comparable complete responses (41% and 33%, p=0.73) and local control (1-year local progression-free survival, 51% compared with 59%, p=0.89), particularly if they were small (p=0.001), primary (p=0.002), chemonaive (p=0.03). Patients treated with cisplatin were unresponsive. Electrochemotherapy with bleomycin is an effective option for skin tumours of the head and neck and is a feasible alternative in highly selected (small, primary, and not previously treated by chemotherapy) SCC of the oral cavity and oropharynx. © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Introduction The management of skin tumours of the head and neck and squamous cell carcinomas (SCC) of the oral cavity and oropharynx may benefit from tissue-sparing, non-operative ∗ Corresponding author. E-mail addresses: maximizing@hotmail.com , luca.campana@ioveneto.it (L.G. Campana), barbara.mali@fe.uni-lj.si (B. Mali), GSersa@onko-i.si (G. Sersa), beijish@hotmail.com (S. Valpione), carloalbe.giorgi@yahoo.it (C.A. Giorgi), pstrojan@onko-i.si (P. Strojan), damijan.miklavcic@fe.uni-lj.si (D. Miklavcic). treatments. Electroporation, a minimally invasive drug deliv- ery system, may be an appealing treatment for patients with head and neck cancer. 1 Recently electrochemotherapy has become a reliable alternative for patients with skin can- cers, and an established palliative option for those with superficial metastases. 2 It combines an antneoplastic agent – bleomycin or cisplatin– with electroporation, achieved by means of locally-applied, high-voltage, electric pulses. 1 These voltages cause cells to become temporarily permeable to chemotherapy and so increase its cytotoxicity. Elec- trochemotherapy has been standard since 2006 (European Standard Operating Procedures of Electrochemotherapy, http://dx.doi.org/10.1016/j.bjoms.2014.08.004 0266-4356/© 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.