BACKGROUND

The management of patients with recurrent carcinomas of the head and neck that had been treated before by surgery, radiation, and/or chemotherapy presents a considerable problem. The value of the MR-controlled laser-induced thermotherapy (LITT) was analysed as a new palliative treatment modality.

METHOD

LITT was used in five patients with recurrent head and neck squamous cell carcinomas, who had undergone established methods of treatment. One patient with a primary laryngeal carcinoma, who refused surgery, was treated by LITT in addition to radiation. A Nd:YAG laser was used to deliver laser light via an applicator directly into the tissue and to produce tumor necrosis. Using two special MR thermosequences (Thermo-TurboFLASH-, modified FLASH-2 D-Sequenfe) the laser process was controlled on line. The necroses were measured by a static and dynamic area calculation program based on a pixel evaluation.

RESULTS

The induced tumor necroses ranged from 4 cm3 to 28 cm3. In all cases the MR thermosequences showed a loss of the signal up to 15 mm around the top of the applicator. In the post-interventional T1 sequences with intensified contrast, the coagulation necroses were represented as hypovascular areas. No side effects were seen and five of the patients felt an improvement of clinical symptoms.

CONCLUSION

LITT as a minimal invasive, MR-controlled method may be a good alternative in palliative therapy of head and neck carcinomas.