Abstract
BackgroundRadiotherapy 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/DesignThe 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.DiscussionThis 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.
Highlights
Radiotherapy is a critical component of the multidisciplinary management of cancers of the head and neck
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
Twenty-three trials with 1861 patients were reviewed, and the odds ratio of locoregional control was in favour of radiation and hyperthermia (OR = 1.80 (1.50–2.16)) for all tumour sites combined; in the five studies that included only head and neck cancer patients, the results suggest overall improvements when heating was added to radiotherapy (OR = 2.08 (1.28–3.39)) [16]
Summary
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. 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. 20–55 % of patients with locally advanced head and neck cancer will develop locoregional recurrence with overall survival of approximately 40–60 % [6,7,8]. Those treatments are often limited by previous therapy, patient co-morbidities or the presence of
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