U. Bockmuhl et al., USE OF MR-CONTROLLED LASER-INDUCED THERMO THERAPY (LITT) IN THE MANAGEMENT OF RECURRENT SQUAMOUS-CELL CARCINOMAS IN THE HEAD AND NECK, Laryngo-, Rhino-, Otologie, 75(10), 1996, pp. 597-601
Background: The management of patients with recurrent carcinomas of th
e head and neck that had been treated before by surgery, radiation, an
d/or chemotherapy presents a considerable problem. The value of the MR
-controlled laser-induced thermotherapy (LITT) was analysed as a new p
alliative treatment modality. Method: LITT was used in five patients w
ith recurrent head and neck squamous cell carcinomas, who had undergon
e established methods of treatment. One patient with a primary larynge
al carcinoma, who refused surgery, was treated by LITT in addition to
radiation. A Nd:YAG laser was used to deliver laser light via an appli
cator directly into the tissue and to produce tumor necrosis. Using tw
o special MR thermosequences (Thermo-TurboFLASH-, modified FLASH-2 D-S
equenfe) the laser process was controlled on line. The necroses were m
easured by a static and dynamic area calculation program based on a pi
xel evaluation. Results: The induced tumor necroses ranged from 4 cm(3
) to 28 cm(3). In all cases the MR thermosequences showed a loss of th
e signal up to 15 mm around the top of the applicator. In the post-int
erventional T-1 sequences with intensified contrast, the coagulation n
ecroses were represented as hypovascular areas. No side effects were s
een 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.