Abstract : The eectiveness of electrochemotherapy (ECT) in local eradication of tumours in human
and veterinary medicine has been proven. ECT consists of increasing the uptake of cytotoxic drugs
by means of pulsed electric fields (PEFs) that transiently permeabilise the cell membrane. Still, this
tumour treatment includes some drawbacks that are linked to the characteristics of the intense electric
pulses (EPs) used. Meanwhile, the emerging field of cancer therapies that are based on the application
of non-thermal plasmas (NTP) has recently garnered interest because of their potentialities as rich
sources of reactive species. In this work, we investigated the potential capabilities of the combined
application of indirect NTP treatment and microsecond PEFs (sPEFs) to outperform in vitro cell
electropermeabilisation, the basis of ECT. Thus, phosphate-buered saline (PBS) was plasma-treated
(pPBS) and used afterwards to explore the eects of its combination with sPEFs. Analysis of two
dierent cell lines (DC-3F Chinese hamster lung fibroblasts and malignant B16-F10 murine melanoma
cells), by flow cytometry, revealed that this combination resulted in significant increases of the level
of cell membrane electropermeabilisation, even at very low electric field amplitude. The B16-F10
cells were more sensitive to the combined treatment than DC-3F cells. Importantly, the percentage of
permeabilised cells reached values similar to those of cells exposed to classical electroporation field
amplitude (1100 V/cm) when the cells were treated with pPBS before and after being exposed only
to very low PEF amplitude (600 V/cm). Although the level of permeabilisation of the cells that are
treated by the pPBS and the PEFs at 600 V/cm is lower than the level reached after the exposure to
sPEFs alone at 1100 V/cm, the combined treatment opens the possibility to reduce the amplitude of
the EPs used in ECT, potentially allowing for a novel ECT with reduced side-eects