title: Magnetic resonance-guided high-intensity focused ultrasound combined with radiotherapy for palliation of head and neck cancer-a pilot study.
abstract: BACKGROUND
  Radiotherapy is a critical component of the multidisciplinary management of cancers of the head and neck. It may comprise the primary curative treatment modality or is used in an adjuvant setting to improve local control and survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. Although considerable advances have been made recently in the fields of radiotherapy, systemic treatment and surgery for head and neck tumours, locoregional recurrence rates remain high and treatment side effects may have severe impact on patients' quality of life. Magnetic resonance-guided high-intensity focused ultrasound (MRg-HIFU) is a novel technique in the treatment of cancer that has the potential to improve tumour cure rates and decrease treatment-related toxicity. Clinical applications of HIFU are being used increasingly for the treatment of several tumour sites, for example uterine leiomyomas and prostate cancer.
  
  
  METHODS
  The pilot study presented here is an initial step toward utilizing MRg-HIFU for head and neck cancer treatment. The rationale for novel treatment options in head and neck cancer is reviewed as well as emerging evidence that support the increasing clinical utilization of MRg-HIFU.
  
  
  CONCLUSIONS
  This pilot study aims to assess safety, toxicity and feasibility of MRg-HIFU treatments to the head and neck region and to evaluate changes caused by MRg-HIFU within the treated tumour regions based on post-treatment MRI.
authors.affiliation: Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: Lee
authors.affiliation: Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada.
authors.forename: Georges
authors.initials: G
authors.lastname: Farha
authors.affiliation: Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada.
authors.forename: Ian
authors.initials: I
authors.lastname: Poon
authors.affiliation: Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada.
authors.forename: Irene
authors.initials: I
authors.lastname: Karam
authors.affiliation: Sunnybrook Health Sciences Centre, Department of Head and Neck Surgery, University of Toronto, Toronto, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Higgins
authors.affiliation: Thunder Bay Regional Research Institute, Department of Physics, Lakehead University, Thunder Bay, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Pichardo
authors.affiliation: Sunnybrook Health Sciences Centre, Department of Medical Physics, University of Toronto, Toronto, Canada.
authors.forename: Kullervo
authors.initials: K
authors.lastname: Hynynen
authors.affiliation: Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada.
authors.forename: Danny
authors.initials: D
authors.lastname: Enepekides