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Randall P. Owen, MD; Carl E. Silver, MD; Thanjavur S. Ravikumar, MD; Allan Brook, MD; Jacqueline Bello, MD; Dwayne Breining, MD

Arch Otolaryngol Head Neck Surg. 2004;130:52-56.

Objectives  To describe the various techniques that have been developed for application of radiofrequency ablation in the palliative treatment of recurrent and advanced head and neck malignant tumors.

Design  Case series with a follow-up of 3 to 18 months.

Setting  Faculty practice, research protocol, tertiary care academic medical center.

Patients  Fifteen treatments were administered over a 3-year period to 12 patients with advanced and/or recurrent tumors. Eleven tumors were squamous cell carcinomas of the oral cavity, oropharynx, and maxillary sinus, and 1 tumor was a medullary thyroid carcinoma. Three of the 12 patients were treated on 2 separate occasions. Patients were selected as a referred sample and sent specifically for treatment with radiofrequency ablation because they were not candidates for the standard curative options of radiation or surgery. No patient refused enrollment, nor were any patients withdrawn because of adverse events.

Intervention  Radiofrequency ablation is a method of localized hyperthermia resulting in tissue necrosis. Ninety to 150 W of energy is applied, achieving intratumoral temperatures of 60 to 110°C for 5 to 15 minutes per ablation. Techniques have been developed to apply radiofrequency ablation under direct vision, endoscopically, percutaneously, and with ultrasound and computed tomographic guidance.

Results  The radiofrequency ablation probe was accurately placed and treatment administered on 15 occasions. No perioperative deaths occurred. One patient suffered a stroke. Subjective patient improvement was reported with regard to pain (n = 9), appearance (n = 3), and function (n = 4).

From the Department of Surgery, Head and Neck Division (Drs Owen, Silver, and Ravikumar) and the Departments of Neuroradiology (Drs Brook and Bello) and Pathology (Dr Breining), Montefiore Medical Center of the Albert Einstein College of Medicine, Bronx, NY. The authors have no relevant financial interest in this article.