Electrochemotherapy in the Treatment of Bone Metastases: A Narrative Review.

Bone is the third most common site for metastases, frequently leading to skeletal-related events (SREs) such as pain, metastatic epidural spinal cord compression (MESCC), and pathological fractures all of which significantly impact patients' quality of life. In recent years, minimally invasive image-guided therapies have been developed to achieve local tumor control, alleviate pain, and improve functionality, often in conjunction with long-established treatments (chemotherapy, radiation, surgery) and analgesics. Cementoplasty and thermal ablation have demonstrated proven efficacy and safety; however, certain challenging cases remain due to anatomical or tumor-related factors. Innovative techniques such as electrochemotherapy (ECT) are emerging to address these clinical challenges. This review provides an overview of ECT, its role in treatment protocols, and recent data regarding its efficacy in managing bone metastases, with a focus on local control, pain relief, and safety.