📖 What is electrochemotherapy (ECT)?
Electrochemotherapy (ECT) is an oncological technique that combines local chemotherapy (bleomycin) with electrical pulses (electroporation) to increase the permeability of tumour cells and optimise the cytotoxic effect. It can treat cutaneous and subcutaneous tumours, notably in-transit metastases, melanomas, basal cell carcinomas or sarcomas.
ECT is performed in the operating theatre or the interventional radiology suite, under general anaesthesia, as a day case or short hospital stay. It is particularly suited to multiple skin lesions resistant to conventional treatments. Local complete response rates exceed 80% for small lesions.
What are the expected benefits?
Electrochemotherapy can be offered to treat cutaneous or subcutaneous tumours, particularly when surgery or radiotherapy are no longer possible. The expected benefits are:
- Local complete response rate above 80% for small lesions
- Multiplied local efficacy of chemotherapy, while preserving the surrounding healthy tissue
- Treatment of multiple lesions possible in a single session
- Option for inoperable tumours due to their location, or recurring after radiotherapy/surgery
- Day case or short hospital stay, sessions repeatable depending on the response
Main indications
- Cutaneous and subcutaneous metastases (melanoma, breast cancer, head and neck cancer…)
- Superficial tumour recurrences after radiotherapy or surgery
- Inoperable tumours due to their location
- Can be combined with other techniques (ablation, surgery)
Principles and course of the procedure
Electrochemotherapy (ECT) combines low-dose local or systemic chemotherapy (bleomycin or cisplatin) with brief, intense electrical pulses (electroporation) that increase the permeability of tumour cells to the drug.
How does it work?
Session performed under local or light general anaesthesia depending on the extent of the lesions
Injection of the chemotherapy (intravenous or intratumoural depending on the size of the lesions)
Application of electrodes on the lesions and delivery of electrical pulses (8 pulses of 100 µs)
Duration: 30 minutes to 2 hours depending on the number of lesions. Day case
What is the aftercare?
Effets attendus et transitoires :
- Transient local reaction (redness, swelling) in the following days
- Tumour response assessed at 8 weeks
Les complications sont les suivantes :
| Complication | Description | Frequency |
|---|---|---|
| Local pain | Related to electroporation, controlled with painkilleues | Common |
| Inflammatory reaction / skin ulceration | Managed wound healing over a few weeks | 10–20 % |
| Incomplete response | A repeat session may be offered | < 20% for small lesions |
Follow-up after treatment
- Tumour response assessed at 8 weeks
- Repeat sessions possible depending on the response
What are the limits of the treatment?
- Efficacy is higher for small lesions — large lesions may require several sessions or a combined treatment
- The treatment is local and does not treat widespread distant disease
- A managed wound-healing process may be needed in case of a significant skin reaction
Dans tous les cas, d'autres traitements oncologiques restent possibles.
What other techniques and alternatives are available ?
🏥 Surgery
Surgical removal for accessible lesions, the reference treatment when feasible.
☢️ Radiotherapy
An option for skin lesions, in combination with or as an alternative to ECT.
💊 Systemic treatments
Immunotherapy, systemic chemotherapy or targeted therapies depending on the tumour type.
👁️ Soins locaux palliatifs
Dressings and comfort care for ulcerated lesions, when curative treatment is not an option.
What happens if I ultimately decline the treatment?
You remain entirely free in your decision. Your case will be discussed at a multidisciplinary team meeting to consider the alternatives: surgery, radiotherapy, systemic treatment or local care depending on your situation.
What to prepare before the consultation?
- Oncology report with a recent staging work-up
- Photos or measurements of the skin lesions
- Blood tests (full blood count, renal function if bleomycin)
📄 Patient information sheet to download
✅ Procedure covered by French national health insurance. No extra fees.