IRE with electro-chemotherapy (IRECT)
A gentle treatment method for advanced cancer and complex recurrences
IRECT is the combination of Irreversible Electroporation and Electrochemotherapy. IRECT is a new therapeutic procedure for prostate cancer. It extends the IRE treatment area, where cells are destroyed shortly after treatment, to include a zone where reversible electroporation (RE) occurs. The RE zone is additionally treated by electrochemotherapy (ECT).
For this treatment, a single dose of a chemotherapy drug is given. Chemotherapeutic agents have been used for many years to treat malignant tumors. Effective treatment with only one chemotherapeutic agent usually requires multiple applications.
The effectiveness of the chemotherapeutic agent is enhanced many times over in the RE zone. This happens because electroporation leads to increased permeability of cell walls. As a result, the chemotherapeutic agent is better absorbed into the tumor cell (Figure 2). Without the chemotherapeutic agent, reversible electroporation in this area is not sufficient to destroy the cells.
IRECT is already successfully used in the treatment of skin and bone tumors. It is the gentlest method for treating large areas of tumorous tissue. This is because IRECT can treat cancer cells that are located further away from the IRE electrodes. No damage is caused to surrounding organs or tissues (e.g., bladder sphincter and bowel when treating the prostate).
Indications for carcinoma treatment with combined IRECT therapy
To date, it is not fully understood in which indications combined treatment of IRE and chemotherapeutic agents should take place. Further research is being conducted in this direction. Only patients who refuse alternative therapies are treated.
Possible areas of application include:
- Patients with high-grade prostate carcinoma
- Patients with prostate cancer that has already invaded the rectum or bladder wall
- Patients with incipient affection of the sphincter muscle, which could lead to incontinence
- Patients with complex focal recurrences after surgery, HIFU (high-intensity focused ultrasound), or radiation treatment.
- Patients with metastases in the lymph nodes, bones or, in certain cases, metastases in other organs
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IRECT treatment procedure
Our therapies are planned and carried out as precisely as possible for each individual patient.
Once the IRE needles are positioned, a chemotherapeutic agent is injected. After only eight minutes, it has spread throughout the body. Now the localized, short electrical surges are performed. This creates the IRE and RE areas. Within the IRE field, all tumor cells are destroyed immediately thereafter. The tumor cells in the RE field take up large amounts of bleomycin and therefore die gradually within up to 4 weeks.
After the treatment is completed, patients stay overnight in our private clinic and can usually go home the next day. You will return to your normal everyday life after just a few days.
Following the successful introduction of NanoKnife therapy, we now offer IRECT, another treatment procedure that allows us to treat advanced cancers in larger areas as well as recurrences gently and effectively.
Since every patient is unique and every case is different, contact us to learn which treatment procedure is right for you. Our medical specialists will advise you on all treatment options.
Right: Time course of ECT treatment. Figure based on a chart by Haberl et al.