Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. May 24, 2021; 12(5): 367-381
Published online May 24, 2021. doi: 10.5306/wjco.v12.i5.367
Reduction of muscle contraction and pain in electroporation-based treatments: An overview
Roberta Fusco, Elio Di Bernardo, Valeria D'Alessio, Simona Salati, Matteo Cadossi
Roberta Fusco, Elio Di Bernardo, Valeria D'Alessio, Simona Salati, Matteo Cadossi, Department of Medical Oncology, IGEA SpA, Carpi 41012, Modena, Italy
Author contributions: Fusco R, Di Bernardo E, D'Alessio V wrote the manuscript; Salati S and Cadossi M revised the manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Valeria D'Alessio, Department of Medical Oncology, IGEA SpA, Via Parmenide 10A, Carpi 41012, Modena, Italy.
Received: December 23, 2020
Peer-review started: December 24, 2020
First decision: March 17, 2021
Revised: March 17, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: May 24, 2021
Research background

In electrochemotherapy (ECT), pain and muscular contractions were reported as the most frequent drawbacks.

Research motivation

To review aimed to assess the literature describing technical advances intended to reduce muscle contraction and pain associated with electroporation (EP) effects.

Research objectives

The objective was to present an overview of different protocols proposed in the literature that aim to reduce muscle contraction in both ECT and irreversible EP treatments.

Research methods

Thirty-three published studies reporting different protocol designs and electrode geometries were selected for analysis.

Research results

Both high frequency and bipolar/biphasic pulses can be used to reduce pain and muscle contractions in patients who undergo EP treatments. Moreover, adequate electrode design can lower EP-related morbidity.

Research conclusions

Pain reduction in EP-based treatments can be achieved by appropriately defining the protocol parameters and the electrode design.

Research perspectives

The desired results can be achieved with high frequency and/or bipolar/biphasic pulses.