Effective Treatment of Cervical Lymph Node Metastasis of Breast Cancer by Low Voltage High-Frequency Electrochemotherapy

  • Bahram Mofid Department of Clinical Oncology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Zeinab Shankayi Department of Medical Physics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
  • Kambiz Novin Department of Clinical Oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Sadegh Dehghani Department of Medical Physics, Tehran University of Medical Sciences, Tehran, Iran.
  • Morteza Shankayi Department of Mechanic, School of Engineering, Tarbiat Modares University, Tehran, Iran.
  • Hamidreza Haghighatkhah Department of Radiology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • S. Mohammad Firoozabadi Mail Department of Medical Physics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Low voltage, High frequency, Electrochemotherapy, Bleomycin, Lymphadenopathy


Electrochemotherapy (ECT) is a new local treatment method for solid and superficial tumors. During this new technique, patients experience an unpleasant sensation and slight edema. Most unpleasant and painful is mainly attributed to muscle contractions provoked by high amplitude and low repetition frequency pulses. Recently, we showed that electrochemotherapy using low voltage and higher repetition frequency (LVHF ECT) is an effective tool for inhibiting tumor growth and inducing cell permeabilization. Low voltage high-frequency electrochemotherapy was developed and optimized in vitro and in vivo which and can be used in the clinic. In the present study, we report a case of cervical lymph node metastasis of breast cancer treated by the technique. In our case, LVHF ECT was successful in reducing the size and palliating the symptoms of cervical lymph node metastasis in clinical conditions, whereas other approaches were inefficient. Our electrochemotherapy technique shows good clinical results. However, more studies on this new method are necessary to prove that LVHF ECT can be considered as a standard treatment modality.


Sersa G, Miklavcic D, Cemazar M, Rudolf Z, Pucihar G, Snoj M. Electrochemotherapy in treatment of tumors. Eur J Surg Oncol 2008;34:232-40.

Miklavcic D, Snoj M, Zupanic A, Kos B, Cemazar M, Kropivnik M, et al. Towards treatment planning and treatment of deep-seated solid tumors by electrochemotherapy. Biomed Eng Online 2010;9:1-12.

Heller R, Jaroszeski MJ, Reintgen DS, Puleo CA, DeConti RC, Gilbert RA, et al. Treatment of cutaneous and subcutaneous tumors with electrochemotherapy using intralesional bleomycin. Cancer 1998;83:148-57.

Mir L, Gehl J, Sersa G, Collins C, Garbay J, Billard V, et al. Standard operating procedures of the

electrochemotherapy: instructions for the use of bleomycin or cisplatin administered either systemically or locally and electric pulses delivered by the CliniporatorTM by means of invasive or noninvasive electrodes. EJC Suppl. 2006; 4:14–25.

Sersa G, Kranjc S, Scancar J, Krzan M, Cemazar M.Electrochemotherapy of Mouse Sarcoma Tumors Using Electric Pulse Trains with Repetition Frequencies of 1 Hz and 5 kHz. J Membrane Biol 2010;236:155-62.

Miklavčič D, Pucihar G, Pavlovec M, Ribarič S, Mali M, Maček-Lebar A, et al. The effect of high frequency electric pulses on muscle contractions and antitumor efficiency in vivo for a potential use in clinical electrochemotherapy. Bioelectrochemistry 2005;65:121-8.

Pucihar G, Mir LM, Miklavčič D. The effect of pulse repetition frequency on the uptake into electropermeabilized cells in vitro with possible applications in electrochemotherapy. Bioelectrochemistry 2002;57:167-72.

Horiuchi A, Nikaido T, Mitsushita J, Toki T, Konishi I, Fujii S. Enhancement of antitumor effect of bleomycin by low-voltage in vivo electroporation: A study of human uterine leiomyosarcomas in nude mice. Int J Cancer 2000;88:640-4.

Entin I, Plotnikov A, Korenstein R, Keisari Y. Tumor Growth Retardation, Cure, and Induction of Antitumor Immunity in B16 Melanoma-bearing Mice by Low Electric Field-enhanced Chemotherapy. Clin Cancer Res 2003;9:3190-7.

Shankayi Z, Firoozabadi S, Hassan Z. Comparison of low voltage amplitude electrochemotherapy with 1 Hz and 5 kHz frequency in volume reduction of mouse mammary tumor in Balb/c Mice. Koomesh 2012;13:486- 90.

Shankayi Z, Firoozabadi S. Antitumor Efficiency of Electrochemotherapy by High and Low Frequencies and Repetitive Therapy in the Treatment of Invasive Ductal Carcinoma in Balb/c Mice. Cell J 2012;15:110- 5.

Shankayi Z, Firoozabadi S. Tumor Growth Inhibited by Low-Voltage Amplitude and 5-kHz Frequency Electrochemotherapy. J Membr Biol 2011;244:121- 8.

Mahna A, Firoozabadi S, Shankayi Z. The Effect of ELF Magnetic Field on Tumor Growth after Electrochemotherapy. J Membrane Biol 2014;247:9-15.

Soteldo J, di Pietro A, Tosti G, Mosconi M, Baldini F, Rastrelli M, et al. The treatment of cutaneous and subcutaneous lesions with electrochemotherapy with bleomycin. Cancer 1991;83:148-57.

Giardino R, Fini M, Bonazzi V, Cadossi R, Nicolini A, Carpi A. Electrochemotherapy a novel approach to the treatment of metastatic nodules on the skin and subcutaneous tissues. Biomed Pharmacother 2006;60:458-62.

Larkin JO, Collins CG, Aarons S, Tangney M, Whelan M, O'Reily S, et al. Electrochemotherapy: aspects of preclinical development and early clinical experience. Ann Surg 2007;245:469.

Sersa G, Cufer T, Paulin SM, Cemazar M, Snoj M.Electrochemotherapy of chest wall breast cancer recurrence. Cancer Treat Rev 2012;38:379-86.

Marty M, Sersa G, Garbay JR, Gehl J, Collins CG, Snoj M, et al. Electrochemotherapy–An easy, highly effective and safe treatment of cutaneous and subcutaneous metastases: Results of ESOPE (European Standard Operating Procedures of Electrochemotherapy) study. EJC Suppl 2006;4:3-13.

Macri GF, Greco A, Gallo A, Fusconi M, Marinelli C, Vincentiis M. Use of electrochemotherapy in a case of neck skin metastasis of oral squamous cell carcinoma: Case report and considerations. Head Neck 2014;36:E86-90.

Silve A, Leray I, Mir L. Demonstration of cell membrane permeabilization to medium-sized molecules caused by a single 10 ns electric pulse. Bioelechem 2011;87:260-4.

Zupanic A, Ribaric S, Miklavcic D. Increasing the repetition frequency of electric pulse delivery reduces unpleasant sensations that occur in electrochemotherapy. Neoplasma 2007;54:246-50.

Mansourian M, Firoozabadi S, Shankayi Z, Hassan Z.Magnetic fields with frequency of 217 Hz can reduce cell apoptosis caused by electrochemotherapy. Electromagn Biol Med 2013;32:70- 8.

Shankayi Z, Firoozabadi S, Saraf Hassan Z. The Endothelial Permeability Increased by Low Voltage and High Frequency Electroporation. J Biomed Phys Eng 2013;3:87-92.

Shankayi Z, Firoozabadi S, Hassan ZS. Optimization of Electric Pulse Amplitude and Frequency In Vitro for Low Voltage and High Frequency Electrochemotherapy. J Membr Biol 2014;247:147-54.

Shankayi Z, Firoozabadi S, Hssan Z. The effect of rectangular electric pulse number in electrochemotherapy by low voltage and high frequency on breast tumors in Balb/c mice. Yakhteh Med J 2010;12:381-4.

How to Cite
Mofid B, Shankayi Z, Novin K, Dehghani S, Shankayi M, Haghighatkhah H, Firoozabadi SM. Effective Treatment of Cervical Lymph Node Metastasis of Breast Cancer by Low Voltage High-Frequency Electrochemotherapy. Acta Med Iran. 55(4):268-271.
Case Report(s)