## 3 Results
### Case 2: With Intratumoral Administration Calcium Ions and Intravenous, Simultaneous CTH  
A 60-year-old male without comorbidities was qualified to undergo ablation after stabilization of the size of the pancreatic tumor according to RECIST criteria. The patient had been operated on 9 months before admission and underwent a palliative, bypass procedure later with FOLFOXX (folinic acid calcium foliate, fluorouracil, and oxaliplatin) chemotherapy. A CT image of the patient is presented in Figure 1C. CT before ablative treatment revealed a pancreatic tumor of size \(2\times 3\) cm with infiltration of the mesenteric vein. The mesentery showed high density. There was no sign of metastatic disease. The patient experienced pain (VAS score was 6) and was treated with opioids and paresthesia of the hand and legs. Preoperative MRI was not performed because of the metal prosthesis of the common bile duct (SEMS, i.e. self-expandable metal stent).  
The clinical parameters of the patient are shown in Table 1.  
The patient agreed to an intratumoral administration of calcium ions and intravenous, intraoperative administration of cisplatin. The open procedure under general anesthesia with an intraoperative US was performed. The metal prosthesis was removed before the ablative procedure. The operating time was 3 h 10 min. The procedure consisted of 11 sessions, one replacement of the needles, intratumoral administration of calcium ions after the ablative procedure, and intravenous cisplatin administration before the ablative procedure.  
Postoperatively, the patient showed no severe complications. The amylase level was 61 U/L, and it decreased to 33 U/L. The VAS score after the procedure decreased to 4. Two weeks after the procedure, the patient developed pancreatic fistula type B with approximately 10-20 mL secretion per 24 h. However, this did not affect the further \"treatment plan\". Necrosis of the tumor was  
\begin{table}
\begin{tabular}{c c c} \hline \hline  & **Case 1 IRE with Calcium** & **Case 2 IRE with Calcium and Cisplatin** \\  & **Electroporation** & **Electroporation** \\ \hline Sex & Male & Male \\ \hline Age & 58 years & 60 years \\ \hline WHO/ECOG & & \\ performance status * & 1 & 1 \\ \hline Body weight & 83 kg & 62 kg \\ \hline BMI & 23.67 & 19.6 \\ \hline Comorbidities according & & \\ to the Charslon & 2 & 2 \\ Comorbidity Index & & \\ \hline The VAS scale ** & 2 & 6 \\ \hline Analgesics taken & NSAIDs, periodically & Opioids \\ \hline Tumor size in [mm] & CT 61 x 49 & After 3 months CT 52 & CT 20 x 30 mm MR \\  & MR 52 x 52 & \(\times\) 56 MRI 56 x 59 & not done \\ \hline Chemotherapy before & 5 cycles of nab-paclitaxel + GCB with & \\  & poor tolerance & 12 cycles of FOLFOX chemotherapy \\ \hline Ca 19-9 (U/mL) level *** & Before the procedure 14 & After the procedure 28.36 \\ \hline Amylase level (U/L) & Before the procedure 48 & After the procedure 478 \\ \hline Postoperative & & \\ complications (the & Acute pancreatitis level III/IV & Pancreatic fistula type B level II \\ Clavien-Dindo scale) & & \\ \hline \hline \end{tabular}  
* WHO/ECOG performance status—World Health Organization/Eastern Cooperative Oncology Group performance status to evaluate patient’s level of functioning in the normal life functioning. ** VAS scale—the visual analog scale is a validated, subjective measure for acute and chronic pain. *** Carbohydrate antigen 19-9, marker of pancreatic cancer.  
\end{table}
Table 1: Patients’ comparison at the time of qualification for the procedure and immediately after the procedure. VAS: visual analog scale.  
apparent \"immediately after\" the CT scan. There were no signs of pancreatitis. Complications after the procedure were assessed at grade II in the Clavien-Dindo scale. Table 2 shows the IRE conditions and pharmacological treatment applied during all sessions.