Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients

Abstract Electrochemotherapy (ECT) is a minimally invasive treatment option for basal cell carcinoma (BCC), which is particularly advantageous in the elderly population. This study evaluated the long-term effects of treating BCC in older patients using ECT with a reduced dose of bleomycin (10,000 IU...

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Main Authors: Aleš Grošelj, Črt Jamšek, Simona Kranjc Brezar, Maja Čemažar, Maša Omerzel, Luka Pušnik, Gregor Serša
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-93104-3
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author Aleš Grošelj
Črt Jamšek
Simona Kranjc Brezar
Maja Čemažar
Maša Omerzel
Luka Pušnik
Gregor Serša
author_facet Aleš Grošelj
Črt Jamšek
Simona Kranjc Brezar
Maja Čemažar
Maša Omerzel
Luka Pušnik
Gregor Serša
author_sort Aleš Grošelj
collection DOAJ
description Abstract Electrochemotherapy (ECT) is a minimally invasive treatment option for basal cell carcinoma (BCC), which is particularly advantageous in the elderly population. This study evaluated the long-term effects of treating BCC in older patients using ECT with a reduced dose of bleomycin (10,000 IU/m2) and compared the results to patients who received the standard dose of bleomycin (15,000 IU/m2). The retrospective analysis included 116 patients aged over 65 years with 257 histologically confirmed BCCs. Tumors were treated with either the standard dose (n = 82) or the reduced dose (n = 175) of bleomycin. The results showed that the recurrence rate was comparable between the groups, particularly in the first year after treatment. The reduced-dose group exhibited a greater recurrence rate after the first year, which may be attributed to a weaker local immune response due to the de-escalated dose of bleomycin. Nonetheless, administering a standard bleomycin dosage as a salvage treatment in the event of recurrence proved highly effective. These findings suggest that ECT with a reduced bleomycin dose is a viable option for treating BCC in elderly patients, particularly those with shorter life expectancy.
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issn 2045-2322
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spelling doaj-art-c7783fca874448aabf85043159de82a62025-08-20T03:14:05ZengNature PortfolioScientific Reports2045-23222025-04-011511710.1038/s41598-025-93104-3Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patientsAleš Grošelj0Črt Jamšek1Simona Kranjc Brezar2Maja Čemažar3Maša Omerzel4Luka Pušnik5Gregor Serša6Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center LjubljanaDepartment of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center LjubljanaDepartment of Experimental Oncology, Institute of Oncology LjubljanaDepartment of Experimental Oncology, Institute of Oncology LjubljanaDepartment of Experimental Oncology, Institute of Oncology LjubljanaInstitute of Anatomy, Faculty of Medicine, University of LjubljanaDepartment of Experimental Oncology, Institute of Oncology LjubljanaAbstract Electrochemotherapy (ECT) is a minimally invasive treatment option for basal cell carcinoma (BCC), which is particularly advantageous in the elderly population. This study evaluated the long-term effects of treating BCC in older patients using ECT with a reduced dose of bleomycin (10,000 IU/m2) and compared the results to patients who received the standard dose of bleomycin (15,000 IU/m2). The retrospective analysis included 116 patients aged over 65 years with 257 histologically confirmed BCCs. Tumors were treated with either the standard dose (n = 82) or the reduced dose (n = 175) of bleomycin. The results showed that the recurrence rate was comparable between the groups, particularly in the first year after treatment. The reduced-dose group exhibited a greater recurrence rate after the first year, which may be attributed to a weaker local immune response due to the de-escalated dose of bleomycin. Nonetheless, administering a standard bleomycin dosage as a salvage treatment in the event of recurrence proved highly effective. These findings suggest that ECT with a reduced bleomycin dose is a viable option for treating BCC in elderly patients, particularly those with shorter life expectancy.https://doi.org/10.1038/s41598-025-93104-3BleomycinDe-escalationHead and neckElectrochemotherapyNonmelanoma skin cancer
spellingShingle Aleš Grošelj
Črt Jamšek
Simona Kranjc Brezar
Maja Čemažar
Maša Omerzel
Luka Pušnik
Gregor Serša
Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients
Scientific Reports
Bleomycin
De-escalation
Head and neck
Electrochemotherapy
Nonmelanoma skin cancer
title Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients
title_full Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients
title_fullStr Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients
title_full_unstemmed Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients
title_short Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients
title_sort long term outcomes of reduced dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients
topic Bleomycin
De-escalation
Head and neck
Electrochemotherapy
Nonmelanoma skin cancer
url https://doi.org/10.1038/s41598-025-93104-3
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