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Metastatic Head and Neck Malignancy Treated Using MRI Guided Interstitial Laser Phototherapy

Metastatic Head and Neck Malignancy Treated Using MRI Guided Interstitial Laser Phototherapy

Authors :
Dan J. Castro
Paul H. Ward
J. Soudant
Anthony Nyerges
Lester J. Layfield
Romaine E. Saxton
Hooshang Kangarloo
Robert B. Lufkin
Bradley A. Jabour
Source :
The Laryngoscope. 102:26
Publication Year :
1992
Publisher :
Wiley, 1992.

Abstract

Interstitial laser phototherapy (ILP) guided by magnetic resonance imaging (MRI) may become an attractive adjunctive modality for the treatment of deep and surgically inaccessible tumors of the head and neck when accurate methods of laser dosimetry and "real-time" monitoring techniques with the MRI are introduced. We recently demonstrated in ex vivo and in vivo models, a linear relationship between levels of laser energies, thermal profiles, MR signal intensity changes, and histopathological tissue damage. Results of treatment in a patient with an unresectable large right jugulodigastric metastatic squamous carcinoma using new approach of MRI guided ILP are now reported. The patient complained of significant right-sided neck pain and headaches secondary to a rapidly growing metastatic lymphadenopathy which recurred after previous surgery, radiation, and chemotherapy. Two treatment sessions were used at an interval of 2 weeks. Each treatment was performed in the MRI suite under heavy sedation. Using a 600-microns bare fiber of the Nd:YAG laser implanted interstitially under MR guidance, the metastatic node was treated at three sites. T1- and T2-weighted images were performed prior to, immediately after, 24 and 48 hours, and 4, 5, 7, 9, 16, and 25 days post-treatment. Successful relief of pain and growth arrest of this node was observed after the second treatment and at the 3-month follow-up. These results demonstrate that this technique of ILP guided by MRI may be feasible in humans, and will become clinically practical when appropriate methods of dosimetry and instrumentation are developed.

Details

ISSN :
0023852X
Volume :
102
Database :
OpenAIRE
Journal :
The Laryngoscope
Accession number :
edsair.doi.dedup.....9cf1a6c36f011dcdad0ebd9348fcf948
Full Text :
https://doi.org/10.1288/00005537-199201000-00005