Survival behavior of patients treated with curative and palliative electrochemotherapy for oral and oropharyngeal cancer: a systematic review.

OBJECTIVE

The primary objective of this review is to assess the survival outcomes of patients affected by oral cavity and oropharyngeal squamous cell carcinoma (SCC) treated with electrochemotherapy (ECT). Secondarily, the authors aim to quantify these outcomes according to treatment intent (curative versus palliative) and to evaluate potential prognostic factors influencing survival.

METHODS

A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive search was carried out in Embase, PubMed, Scopus, and the Cochrane Library databases to identify studies published between January 1998 and April 2025.

RESULTS

Sixteen studies comprising a total of 120 patients were analysed. Overall, ECT was generally well tolerated, with acceptable and manageable adverse events. In the curative-intent cohort, a complete response was achieved in 74% of cases, with a recurrence rate of 12%. One- and two-year disease-free survival (DFS) rates were 94.8% and 77.5%, respectively. Prognostic factors associated with improved survival included early tumor stage, use of adjuvant therapy, and tumors located in the anterior oral cavity. In the palliative-intent cohort, a partial or complete response was observed in 74% of patients, with a one-year DFS of 29.3%. Negative prognostic factors included recurrent disease, prior treatments, and the presence of distant metastases.

CONCLUSIONS

ECT appears to be a promising therapeutic strategy for selected patients with oral cavity and oropharyngeal SCC, particularly in early-stage, treatment-naïve cases. Accurate prognostic stratification is essential to optimize patient selection and improve clinical outcomes.