MR-guided laser-induced thermotherapy of tumours of the head and neck region: First clinical results

Purpose: To analyse the value of MR-guided laser-in duced thermotherapy (LITT) for palliative treatment of recurrent tumours of the head and neck region. Material and methods: 8 patients with recurrent tumours of the head and neck region (squamous cell carcinomas n = 6, pleomorphic adenomas n = 2) underwent MR-controlled LITT. A 7 French laser applicator was inserted under local anaesthesia into the centre of the recurrent tumour. A Nd:YAG laser with a wavelength of 1064 nm was used. Therapy was monitored on-line using special MR thermosequences. Results: Preinterventional contrast-enhanced MRI revealed a recurrent tumour of the head and neck region for all eight patients. All patients tolerated the procedures well under local anaesthesia, with no clinically relevant side effects. The MR thermosequences depicted up to 15 mm diameter areas of less signal near the laser tip. Postinterventional contrast-enhanced MRI revealed hypovascularised areas due to the resulting coagulative necrosis. Coagulative necrosis of 4 cc to 28 cc occurred in all patients, and a reduction of clinical symptoms was achieved in five. Conclusion: The results obtained indicate that minimal invasive LITT can be a therapeutic alternative for palliative treatment of head and neck tumours.