PALLIATIVE LASER THERAPY FOR RECURRENT HEAD AND NECK-CANCER - A PHASE-II CLINICAL-STUDY

Objectives: Laser therapy is becoming a more precise, minimally invasi ve alternative for tumor ablation, Recent reports confirm successful p alliation of pain and functional disabilities in patients with advance d deep carcinoma of the head and neck using interstitial laser phototh erapy (ILT), Study Design, Patients, and Methods: The current study de scribes an ongoing Phase II trial of neodymium/yttrium- aluminum-garne t (Nd:YAG) laser therapy for palliation of advanced head and neck canc er. A total of 40 advanced cancer patients have been entered into this protocol (25 men and 15 women). Results: Nineteen of these patients h ad no evidence of recurrence after ILT with an average follow-up of 11 months (range, 2 to 24 mo). Currently, 19 of these patients are alive , 14 with tumor remission and six with persistent disease. A total of 79 tumor sites received ILT with 43 (54.5%) completely ablated, Strati fied by tumor site, ILT led to a complete response in 21 of 24 in the oral cavity, eight of 28 neck tumors, four of 10 in skin, and 10 of 17 in other sites. The procedure was well tolerated in most cases and wa s repeated at intervals in patients with residual disease or recurrenc es for a total of 118 laser treatments (average, 2.95 treatments per p atient). Conclusions: The results suggest that ILT can be performed sa fely and repeated as needed, and may be less costly than conventional surgery for head and neck cancer. However, additional follow-up is nee ded to obtain convincing evidence of long-term therapeutic benefits.