Radiofrequency ablation of advanced head and neck cancer

Objective: To determine if the application of radiofrequency ablation to advanced head and neck cancer (HNC) would result in local control of the tumor. Design: Radiofrequency ablation was applied to advanced head and neck malignant tumors in the participants of this nonrandomized controlled trial. Setting: Academic tertiary care medical center. Participants: Twenty-one participants with recurrent and/or unresectable HNC who failed treatment with surgery, radiation, and/or chemotherapy were selected for the trial. Patients deemed appropriate for curative standard radiation or surgery were not accepted as participants. Intervention: Radiofrequency ablation was applied to head and neck tumors under general anesthesia and computed tomographic scan guidance. Main Outcome Measures: The primary end point was local control. Computed tomographic scan tumor measurements were used to assess response by standard response evaluation criteria in solid tumors (RECIST) guidelines. Secondary outcome measures included survival and quality of life. Results: Eight of 13 participants had stable disease after intervention. Median survival was 127 days, and an improvement in University of Washington quality-of-life scores was noted. Adverse outcomes included 1 death due to carotid hemorrhage and 2 strokes. Conclusion: Radiofrequency ablation is a palliative treatment alternative that shows promise in addressing the challenges of local control and quality of life in patients with incurable HNC who have failed standard curative treatment.