Electrochemotherapy for Anorectal Tumors: A Narrative Literature Review

Abstract

This narrative review explores the potential role of electrochemotherapy (ECT) in treating anorectal tumors, focusing on its effectiveness, feasibility, and associated toxicities. ECT, which combines chemotherapy with the application of an electric field to enhance drug uptake by tumor cells, has shown promise as a local treatment, particularly in cases where conventional therapies such as radiotherapy have been exhausted or are unsuitable. The review, conducted according to SANRA guidelines, included 18 studies, on ECT in anorectal tumors, ranging from preclinical trials in dogs to case reports and clinical studies in humans. The findings indicate that ECT can achieve high tumor overall response rates (70-100%) with minimal side effects, offering benefits such as tumor reduction and preserved organ function. These results highlight the potential of ECT to provide not only tumor reduction but also the preservation of vital organ function with a relatively low toxicity profile. However, further comparative research is necessary to substantiate its role as a standard therapeutic option. Moreover, the evidence is limited by significant heterogeneity across studies, small sample sizes, and a lack of comparative research with other local treatments like radiotherapy and cryosurgery. Consequently, while ECT appears to be a promising option, particularly for palliative care or in a neoadjuvant setting, it cannot yet be recommended as a standard treatment. Future research should focus on larger, more robust studies with standardized outcomes and explore the potential synergy between ECT and other therapies to establish its place in the treatment of anorectal tumors.

Keywords: anal cancer; anorectal tumors; case reports; clinical trials; colorectal cancer; comparative studies; electrochemotherapy; local treatment; multidisciplinary approach; neoadjuvant therapy; oncological outcomes; palliative care; rectal cancer; toxicity; tumor control.

Figure 1.

PRISMA Flowchart.

Figure 2.

Schematic Representation of an Electrochemotherapy Treatment of an Anorectal Tumor (in Red).