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Electroquimioterapia como abordagem conservadora de membro no melanoma recidivante : descrição de casos clínicos
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A electroquimioterapia consiste na administração de citostáticos, local ou sistemicamente, em combinação com a administração de electroporação celular, de modo a aumentar a permeabilidade da membrana celular e a facilitar a entrada do fármaco [1]. Isto permite a multiplicação da toxicidade dos quimiofármacos que entram nas células tumorais, sem os efeitos adversos sistémicos habituais [2]. Esta abordagem é altamente eficaz, principalmente no tratamento paliativo de cancro localizado na pele e tecido subcutâneo, como o melanoma [2].
Apesar dos seus benefícios, demonstrados em várias séries publicadas, sobretudo na Europa, esta abordagem é ainda pouco utilizada em Portugal, não existindo normas de orientação para a sua aplicação, sobretudo fora do contexto puramente paliativo.
Este Trabalho consiste na análise e descrição de casos clínicos de melanoma maligno localmente avançado e recidivante, em que a electroquimioterapia foi utilizada como abordagem terapêutica única, permitindo a conservação do membro durante um longo período de tempo.
Como base para a sua realização, recorrer-se-á, essencialmente, a entrevistas clínicas de duas doentes com diagnóstico de melanoma maligno, cujos dados serão complementados com os respetivos processos clínicos. Para uma melhor abordagem e compreensão do tema, realizar-se-á uma breve revisão teórica, com consulta de literatura específica sobre a electroquimioterapia e a sua aplicação no melanoma.
Electrochemotherapy consists on the administration of cytostatics, locally or systemically, in combination with the administration of cellular electroporation, in order to increase the permeability of the cell membrane and to facilitate the drug entry [1]. This allows the multiplication of the toxicity of the chemodrugs entering the tumour cells, without the usual systemic adverse effects [2]. This approach is highly effective, particularly in the palliative treatment of cancer located in the skin and in subcutaneous tissue, such as melanoma [2]. Despite its benefits, demonstrated in several published series, especially in Europe, this approach is still little used in Portugal, and there are no guidelines for its application, especially outside the purely palliative context. This work consists in the analysis and description of clinical cases of locally advanced and recurrent malignant melanoma, in which electrochemotherapy was used as an unique therapeutic approach, allowing the preservation of the limb for a long period of time. As a basis for its achievement, it will be resorted, essentially, to clinical interviews of two patients diagnosed with malignant melanoma, whose data will be complemented with the respective clinical files. For a better approach and understanding of the subject, a brief theoretical review will be carried out, with specific literature on electrochemotherapy and its application in the melanoma.
Electrochemotherapy consists on the administration of cytostatics, locally or systemically, in combination with the administration of cellular electroporation, in order to increase the permeability of the cell membrane and to facilitate the drug entry [1]. This allows the multiplication of the toxicity of the chemodrugs entering the tumour cells, without the usual systemic adverse effects [2]. This approach is highly effective, particularly in the palliative treatment of cancer located in the skin and in subcutaneous tissue, such as melanoma [2]. Despite its benefits, demonstrated in several published series, especially in Europe, this approach is still little used in Portugal, and there are no guidelines for its application, especially outside the purely palliative context. This work consists in the analysis and description of clinical cases of locally advanced and recurrent malignant melanoma, in which electrochemotherapy was used as an unique therapeutic approach, allowing the preservation of the limb for a long period of time. As a basis for its achievement, it will be resorted, essentially, to clinical interviews of two patients diagnosed with malignant melanoma, whose data will be complemented with the respective clinical files. For a better approach and understanding of the subject, a brief theoretical review will be carried out, with specific literature on electrochemotherapy and its application in the melanoma.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Electroquimioterapia Eletroporação Melanoma Conservação Membro