{"id":1344,"date":"2025-10-06T04:51:09","date_gmt":"2025-10-06T04:51:09","guid":{"rendered":"https:\/\/persiantarava.me\/en\/?p=1344"},"modified":"2025-10-06T04:51:09","modified_gmt":"2025-10-06T04:51:09","slug":"successful-treatment-of-a-jaw-tumor-with-the-pars-tarava-electrochemotherapy-device","status":"publish","type":"post","link":"https:\/\/persiantarava.me\/en\/2025\/10\/06\/successful-treatment-of-a-jaw-tumor-with-the-pars-tarava-electrochemotherapy-device\/","title":{"rendered":"Treatment of a jaw tumor with the Pars Tarava electrochemotherapy device \u2014 a successful case report and comprehensive review"},"content":{"rendered":"\n
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Treatment of a jaw tumor with the Pars Tarava electrochemotherapy device \u2014 a successful case report and comprehensive review<\/strong>
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In recent years, electrochemotherapy (ECT)<\/a> has emerged as an innovative approach for treating malignant tumors. This method combines low-dose chemotherapy with the application of short, high-intensity electric fields, aiming to increase the penetration of chemotherapeutic agents into tumor cells. Treating a jaw tumour with electrochemotherapy can be a minimally invasive option for patients who are not candidates for surgery or radiotherapy, or for whom those interventions carry a high risk, particularly elderly patients. In this article, we present a thorough introduction to the mechanism of ECT, the pharmacology of bleomycin, the scientific evidence for treating head and neck tumors (especially the jaw), and a case report of an 83-year-old patient with a lower-jaw tumor treated using the Pars Tarava electrochemotherapy device.<\/p>\n\n\n\n

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Understanding electrochemotherapy and electroporation<\/strong><\/h2>\n\n\n\n
\"Treatment<\/figure>\n\n\n\n

Electrochemotherapy (ECT) is a technique in which low-dose chemotherapeutic drugs \u2014 typically bleomycin or cisplatin \u2014 are used in conjunction with the application of short, high-intensity electrical pulses to the tumor. The electrical pulses increase cell membrane permeability (the phenomenon of electroporation<\/a>), allowing hydrophobic and bulky molecules like bleomycin to enter cells more easily. As a result, even very low drug doses can exert substantial cytotoxic effects on cancer cells; it is estimated that ECT increases the effectiveness of bleomycin by 300 to 700 times.<\/p>\n\n\n\n

Electroporation exists in two forms: reversible and irreversible<\/a>. In electrochemotherapy, pulses are configured to transiently increase membrane permeability for a few minutes without causing permanent structural damage to the membrane, thereby permitting greater drug uptake into the cell. Besides enhancing drug entry, this phenomenon induces a temporary vascular lock in the tumor and increases drug retention within the tumor tissue. It also stimulates an immune response against tumor cells, which can help eliminate residual tumor remnants.<\/p>\n\n\n\n

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Application of electrochemotherapy in head and neck tumors<\/strong><\/h2>\n\n\n\n

Head and neck tumors \u2014 including skin cancers, oral mucosal tumors, salivary gland cancers, and jaw tumors \u2014 can be challenging to treat surgically or with radiotherapy due to the complex anatomy of the region and the proximity of vital structures. Electrochemotherapy, as a local and minimally invasive method, has proven effective in controlling such tumors. In a clinical study of 33 patients with cutaneous head and neck cancers, 82% achieved a complete response and 18% a partial response after ECT; seven months later, 96% of patients had wound sites resembling normal skin, and oral and ocular functions were preserved. These results indicate that ECT not only controls tumors but also yields favorable cosmetic and functional outcomes.<\/p>\n\n\n\n

Other studies show that tumor response to ECT depends on tumor size; according to NICE guidelines, the complete response rate was 66% for tumors smaller than 1.5 cm, 36% for tumors 1.6\u20133 cm, and 28% for tumors larger than 3 cm. In another study on patients with cutaneous metastases, an objective response rate of 85% and a complete response rate of 74% were reported. These findings highlight the importance of patient selection and tumor size in determining ECT success. For deep-seated head and neck tumors \u2014 particularly jaw tumors and deep lymph node metastases \u2014 the use of needle electrodes<\/a> and treatment planning is critically important.<\/p>\n\n\n\n

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Clinical evidence and study results<\/strong><\/h2>\n\n\n\n

Response rates and the impact of tumor size<\/strong><\/h3>\n\n\n\n

A review of multiple studies indicates that tumor size is a key determinant of response to electrochemotherapy. In an analysis of 446 patients with cutaneous metastases, the complete response rate for tumors smaller than 1.5 cm was 66%, for tumors 1.6\u20133 cm it was 36%, and for tumors larger than 3 cm it was only 28%. This suggests that ECT is highly effective for small-to-medium tumors and can be used for debulking larger tumors.<\/p>\n\n\n\n

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Response in head and neck tumors<\/strong><\/h3>\n\n\n\n

In the DAHANCA 32 study on mucosal head and neck tumors, bleomycin was administered at 15,000 IU\/m\u00b2 intravenously, yielding an overall response rate (complete + partial) of 58%; in 16 of 17 biopsies taken four weeks after treatment, no cancer cells were found. The EURECA project (2017) in Europe reported a 56% overall response rate (18% complete), with tumors under 3 cm showing better responses. Another study by Piki and colleagues on 36 patients reported a 100% overall response (mostly partial responses).<\/p>\n\n\n\n

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Functional and cosmetic benefits<\/strong><\/h3>\n\n\n\n

One of the significant advantages of electrochemotherapy is the preservation of function and appearance. In head and neck cancers, radical surgery can lead to complications that affect speech, swallowing, and facial appearance. An Acta Dermato-Venereologica report indicated that among 33 patients with cutaneous head and neck cancers, 96% of wounds resembled normal skin and oral and ocular functions were preserved. ECT is particularly valuable for patients who are elderly or medically unfit for surgery or radiotherapy.<\/p>\n\n\n\n

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Quality-of-life improvement<\/strong><\/h3>\n\n\n\n

Alongside tumor control, ECT plays a significant role in improving patients\u2019 quality of life. NICE guidelines reported that 94% of patients experienced improvements after ECT in bleeding, wound condition, appearance, daily activities, social relationships, or pain control. This suggests that ECT not only treats cancer but also reduces distressing symptoms and enhances psychosocial functioning.<\/p>\n\n\n\n

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Case report: Treatment of a lower-jaw tumor in an 83-year-old patient<\/strong><\/h2>\n\n\n\n
\"Treatment<\/figure>\n\n\n\n

Patient characteristics<\/strong><\/h3>\n\n\n\n

An 83-year-old female patient presented with a malignant tumor of the lower jaw. The tumor measured approximately 3 \u00d7 2.7 cm<\/strong> on initial examination and caused pain, difficulty chewing, and cosmetic concern. Due to advanced age, comorbidities, and the high risk associated with extensive surgery, the decision was made to treat the jaw tumor with electrochemotherapy. After consultation and review of the medical record, the patient was deemed a suitable candidate for ECT.<\/p>\n\n\n\n

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Planning and preparation<\/strong><\/h3>\n\n\n\n
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  1. Imaging review and planning:<\/em> <\/strong>CT\/MRI imaging was performed to determine the exact tumor location and adjacent structures (major vessels, the inferior alveolar nerve, and the jawbone). Treatment planning was conducted by the hospital medical team in collaboration with Pars Tarava<\/a> to ensure complete coverage of the tumor by the electric field.<\/li>\n\n\n\n
  2. Electrode selection:<\/strong><\/em> Given the tumor\u2019s depth and size, appropriately sized needle electrodes were chosen to ensure a homogeneous electric field covering the entire tumor volume.<\/li>\n\n\n\n
  3. Drug administration:<\/strong><\/em> According to the ESOPE protocol, bleomycin was administered intravenously at a dose of 15,000 IU\/m\u00b2. The patient was instructed to avoid anticoagulants and medications that affect cardiac function prior to the procedure.<\/li>\n<\/ol>\n\n\n\n

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    Treatment steps<\/strong><\/h3>\n\n\n\n
    \"what<\/figure>\n\n\n\n