Ultrasound-guided laser-induced thermal therapy of malignant cervical adenopathy.
OBJECTIVE
Laser-induced thermal therapy (LITT) for cancer is a technique whereby a source of energy (laser, radiofrequency, ultrasonic, cryoenergy, and so on) is directly applied into a tumor at various depths. Recent studies have demonstrated the efficiency of ultrasound (UTZ) and magnetic resonance imaging (MRI) for real- or "near" real-time tumor and vessel identification as well as monitoring and quantifying energy-induced tissue damage. The objective of this study is to report UCLA's experience using UTZ monitoring of Nd:YAG laser thermal ablation of malignant cervical adenopathy in a phase II study.


METHODS
The authors conducted a retrospective study of patients treated at a tertiary medical center.


METHODS
Forty-seven patients with a total of 55 neck tumors were treated on an outpatient basis in the operating room using UTZ for image-guided laser interstitial thermal therapy. Laser energy was delivered through an SLT Nd:YAG laser powered at 30 W (power density: 2,200 J/cm).


RESULTS
Eleven patients had a complete response ranging from 5.5 to 90 months (mean, 22.1 months). Based on the findings of this study, it was possible to show that proximity to the carotid artery was the most relevant factor in projecting patient survival. Patients' individual treatment analysis and final outcome are further discussed.


CONCLUSIONS
LITT ablation of malignant cervical adenopathy was considered safe and feasible. No intraoperative complications occurred. Further development of this technique applying laser energy delivery to mathematical imaging models should lead to more effective tumor palliation as an alternative to surgery.
Bublik
Michael
M
Department of Head and Neck Surgery, University of Miami, Miami, FL, USA.
Sercarz
Joel A
JA
Lufkin
Robert B
RB
Masterman-Smith
Michael
M
Polyakov
Mark
M
Paiva
Paulo B
PB
Blackwell
Keith E
KE
Castro
Dan J
DJ
Paiva
Marcos B
MB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography