{
  "abstract": "Electrochemotherapy (ECT) is a locoregional treatment that combines reversible electroporation with chemotherapy to enhance intracellular drug delivery. Clinical evidence for ECT in large, deep-seated, recurrent, or locally advanced soft tissue tumors remains limited. This pilot study primarily evaluated symptom palliation following bleomycin-based ECT, with objective tumor response and treatment-related toxicity assessed as secondary outcomes. Twenty-five patients with recurrent, locally advanced, or metastatic STS tumors resistant to conventional treatments underwent ECT between 2022 and 2025. Bleomycin (15,000 IU/m²) was administered intravenously, followed by electroporation using variable electrode configurations according to tumor characteristics. The primary outcome was symptom palliation. Secondary outcomes included objective tumor response and treatment-related toxicity, while additional clinical outcomes included quality-of-life changes, limb preservation, local progression-free survival (LPFS), and overall survival (OS). The study population had a median tumor size of 87 mm (range 35–320 mm), and 92% of tumors were ≥ 5 cm. Overall symptom palliation was achieved in 16 of 18 symptomatic patients (88.9%), with pain reduction reported in 12 of 14 patients with severe baseline pain (85.7%) and complete cessation of bleeding and tumor-associated discharge in all eight affected patients. EORTC QLQ-C30 scores improved across all evaluated domains, including Global Health, Physical Function, and Role Function, while Pain and Other Symptoms scores decreased significantly (all P < 0.001). ECT enabled conversion to operability in selected unresectable tumors, and long-term limb preservation was achieved in four of the six patients who were initially considered candidates for amputation. An objective response was observed in 21/25 patients (84.0%, 95% CI: 63.9%–95.5%). After a median follow-up of 13.7 months, the 1-year LPFS and OS rates were 56.0% and 76.0%, respectively. The most frequent adverse events were skin reactions and soft tissue necrosis, which were generally manageable with conservative wound care or outpatient debridement. No serious ECT-related systemic adverse events were reported. ECT was associated with symptom palliation, objective tumor response, and manageable treatment-related toxicity in this pilot cohort. These preliminary findings warrant further evaluation in larger prospective controlled studies. Clinical trial registration number: The clinical trial registration code number was (IRCT20190904044697N8, Registration Date: 2022-10-02).",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "Hassan Younesi Ghale"
    },
    {
      "name": "Habibollah Mahmoodzadeh"
    },
    {
      "name": "Mahdis Bayat"
    },
    {
      "name": "Edris Berhanegard"
    },
    {
      "name": "Sepideh Mansouri"
    },
    {
      "name": "Alireza Naamvari"
    },
    {
      "name": "Alireza Mohamadian"
    },
    {
      "name": "Hossein Ghanaati"
    },
    {
      "name": "Seyed Rouhollah Miri"
    },
    {
      "name": "Mohammad Abdolahad",
      "orcid": "0000-0002-1091-3095"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/87rys3w9h4exz.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-73029-1",
  "fulltext_url": "https://doi.org/10.1038/s41598-026-73029-1",
  "id": "87rys3w9h4exz",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://www.nature.com/articles/s41598-026-73029-1",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "Q"
    ],
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2740|Sarcoma Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223251892",
  "pdf_url": "https://www.nature.com/articles/s41598-026-73029-1.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-22",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/87rys3w9h4exz.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:33Z",
      "native_id": "10.1038/s41598-026-73029-1",
      "source": "crossref",
      "url": "https://www.nature.com/articles/s41598-026-73029-1"
    },
    {
      "first_seen": "2026-10-30T13:45:56Z",
      "native_id": "105f40ac11fa4373be2a426aaa7f0c5a",
      "source": "doaj",
      "url": "https://doi.org/10.1038/s41598-026-73029-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Sarcoma Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Electrochemotherapy in large and deep-seated soft tissue sarcomas: a pilot study on tumor control, limb preservation, and symptom relief",
  "title_text": "Electrochemotherapy in large and deep-seated soft tissue sarcomas: a pilot study on tumor control, limb preservation, and symptom relief",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:20:44Z",
  "url": "https://research.draconitic.com/paper/87rys3w9h4exz",
  "venue": "Scientific Reports",
  "versions": []
}