Outcomes of laser thermal therapy for recurrent head and neck cancer

Sercarz, Joel A.; Bublik, Michael; Joo, Jayne S; Bandiera-Paiva, Paulo; Areco, Kelsy Catherina Nema; Brandalise, Maria Helena; Loh, Christopher; Masterman‐Smith, Michael; Paiva, Marcos B.

doi:10.1016/j.otohns.2009.11.019

Cited by 19 publications

(28 citation statements)

References 20 publications

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“…6,12,18,26,29,30,36 Energy in the form of light is emitted through a saline-or water-cooled catheter and converted to thermal energy within the target tissue. 10,37 The resulting thermal coagulation and damage to intracellular proteins and DNA ultimately leads to cell death.…”

mentioning

confidence: 99%

Does the real-time thermal damage estimate allow for estimation of tumor control after MRI-guided laser-induced thermal therapy? Initial experience with recurrent intracranial ependymomas

Patel

Jethwa

Shetty

et al. 2015

PED

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OBJECT Although control of intracranial ependymomas is highly correlated with degree of resection, it is unknown if the same is true for MRI-guided laser-induced thermal therapy (MRgLITT). The authors report their experience with MRgLITT for ependymoma and examine the utility of the real-time thermal damage estimate (TDE), a recent software advance, with respect to completeness of ablation and impact on tumor control. To the authors' knowledge, this is the largest single-center experience utilizing MRgLITT for recurrent ependymomas. METHODS Five tumors in 4 patients were treated with the Visualase Thermal Therapy System. Two tumors were treated similarly on recurrence. Ablation was performed using a 980-nm diode laser with a real-time image acquisition system. Single-plane TDEs were calculated and compared with the original lesion area to compute percentage area ablated (PAA). Volumetric analysis was performed, and percentage volume ablated (PVA) was estimated and correlated with the TDE. Tumor control was correlated with the TDE and volumetric data during treatment. RESULTS Nine ablations were performed on 5 tumors, 2 of which had multiple recurrences. The average pretreatment lesion volume was 8.4 ± 6.3 cm3, and the average largest 2D area was 5.3 ± 2.7 cm2. The averaged TDE was 3.9 ± 2.1 cm2, average PAA was 80.1% ± 34.3%, and average PVA was 64.4% ± 23.5%. For subtotal ablations, average recurrence time was 4.4 ± 5.3 months; 1 adult case remains recurrence-free at 40 months. Using TDEs, the correlation between recurrence time and PAA was r = 0.93 (p = 0.01), and for PVA was r = 0.88 (p = 0.02). Furthermore, PVA and PAA were strongly correlated (r = 0.88, p = 0.02). CONCLUSIONS Through using the PAA, the real-time TDE correlated with the volume of ablation in this initial investigation. Furthermore, the TDE and volumetric data corresponded to the level of tumor control, with time to recurrence dependent on ablation completeness. MRgLITT may have a role in the management of recurrent ependymomas, especially with recent software advances.

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mentioning

confidence: 99%

Does the real-time thermal damage estimate allow for estimation of tumor control after MRI-guided laser-induced thermal therapy? Initial experience with recurrent intracranial ependymomas

Patel

Jethwa

Shetty

et al. 2015

PED

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“…Böylece lazer ışınının derin dokulara nüfuz ederek dağılmasına neden olur. [43] Nüks baş boyun tümörlerinde kullanılan lazer tedavisinin sonuçları Tablo 6'da verilmiştir.…”

Section: Termal Terapi̇ A-lazer Termal Terapiunclassified

The final resort treatment options of recurrent head and neck cancer

Karakullukçu¹

2017

Kulak Burun Bogaz Ihtis Derg

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ÖZBaş boyun kanserlerinde tedaviye rağmen nüks oranı %30 ila %50 arasında değişmektedir. Nüks görülen hastaların ise %50'den fazlası, kurtarma tedavisine rağmen kaybedilmektedir. Klinik uygulamada tedavi genellikle cerrahi, radyoterapi ve kemoterapiyi kapsamaktadır. Ancak nüks görülen hastalarda bu yöntemler çoğu zaman istenen sonucu verememektedir. Bu derlemede, nüks baş boyun kanserlerinin tedavisinde klinik uygulamada kullanılan yöntemler dışında kalan son yöntemler ve klinik sonuçları sunuldu.Anahtar Sözcükler: Baş boyun kanseri; nüks; tedavi. ABSTRACTDespite treatment, the recurrence rate of head and neck cancers varies between 30 and 50%. More than 50% of the patients with recurrence die, despite rescue therapy. In clinical practice, treatment usually encompasses surgery, radiotherapy, and chemotherapy. However, these methods do not often yield desirable outcomes in patients with recurrence. In this review, we present the final resort methods, except conventional methods used for the treatment of recurrent head and neck cancers in the clinical practice, and their clinical outcomes.Keywords: Head and neck cancer; recurrent; treatment.Baş boyun kanserleri tüm malignitelerin %10'unu oluşturur. Bunların %90'ını ise skuamöz hücreli karsinom oluşturur.[1] Baş boyun kanserlerinin tedavisinde cerrahi sonrası radyoterapi veya kemoradyoterapide başarısızlık oranı %30-50 arasında değişmektedir. Nüks baş ve boyun kanseri olan hastaların %50'den fazlası kurtarma tedavisine rağmen kaybedilmektedir. Cerrahi etkili bir tedavi seçeneğidir. Ancak sık-lıkla nüks tümörler, kafa tabanı, arteriyel damarlar veya çene gibi kritik yapılara infiltrasyonu nedeniyle rezektabl değildir. [2] Nüks baş boyun tümörlerinin cerrahi tedavisinde en geniş metaanaliz çalışmalarından biri olan Goodwin'in çalışmasında 32 yayın taranmış ve 1633 nüks baş boyun kanser hastası değerlen-dirilmiştir. Hastaların %99'unun daha önce radyasyon tedavisi aldığı belirtilmiştir. Bölgelerine göre beş yıllık sağkalım oranı larenks tümörün-de %47.5 (n=293), oral kavite tümöründe %43.4 (n=116), farenks tümöründe %26 (n=266) olarak bulunmuştur. Bölgelerin tümüne baktığımızda beş yıllık sağkalım oranı %39.4 (n=1080) olarak bulunmuştur.[3]

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“…In this work intratumor injection of bleomycin was combined with LITT for esophageal tumors and followed for an average 29 months. The combined minimally invasive procedure proposed has a strong translational potential as a cost effective alternative treatment not only for head and neck but for other accessible inoperable primary and/or recurrent tumors of the chest wall, breast, liver, prostate and colon Chapman, 1998;Mueller-Lisse et al, 1998;Paiva et al, 1998a;Schulze et al, 2002;Vogl et al, 2002a;Vogl et al, 1997;Stafford et al, 2010;Sercarz et al, 2010).…”

Section: Intratumor Injections Of Chemotherapy and Laser For Effectivmentioning

confidence: 99%

“…Peralta et al (2010) et al recently described massive thermal injury to arteries and veins resulting in vascular collapse due to high energy density using the Nd:YAG laser powered at 30-45W for treatment of severe twintwin transfusion syndrome. This is the same energy level used by our group for head and neck thermal ablation (2,200-3,300 J/cm 2 ) of cancer (Bublik et al, 2006;Sercarz et al, 2010). In theory, the peripheral vascular collapse of arteries and veins produced by LITT will isolate blood flow to and from the tumor, thereby impeding drug (CDDP) washout to the rest of the body.…”

Section: Future Developmentmentioning

confidence: 99%