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Glioblastoma Treated With Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy: Safety, Efficacy, and Outcomes
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Glioblastoma Treated With Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy: Safety, Efficacy, and Outcomes
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Journal Article
Glioblastoma Treated With Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy: Safety, Efficacy, and Outcomes
2019
Overview
Abstract
BACKGROUND
Despite the multitude of available treatments, glioblastoma (GBM) remains an aggressive and uniformly fatal tumor. Laser interstitial thermal therapy (LITT) is a novel, minimally invasive treatment that holds promise for treating patients with GBM who are not candidates for traditional open craniotomy. However, due to the recent introduction of LITT into clinical practice, large series that evaluate safety and long-term outcomes after LITT are lacking.
OBJECTIVE
To present our institution's series of over 50 GBM patients treated with LITT, with regard to safety, efficacy, and outcomes.
METHODS
We performed a retrospective descriptive study of patients with histologically proven GBM who underwent LITT. Data collected included demographics, tumor location and volume, tumor genetic markers, treatment volume, perioperative complications, and long-term follow-up data.
RESULTS
We performed 58 LITT treatments for GBM in 54 patients over 5.5 yr. Forty-one were recurrent tumors while 17 were frontline treatments. Forty GBMs were lobar in location, while 18 were in deep structures (thalamus, insula, corpus callosum). Average tumor volume was 12.5 ± 13.4 cm3. Average percentage of tumor treated with the yellow thermal damage threshold (TDT) line (dose equivalent of 43°C for 2 min) was 93.3% ± 10.6%, and with the blue TDT line (dose equivalent of 43°C for 10 min) was 88.0% ± 14.2%. There were 7 perioperative complications (12%) and 2 mortalities (3.4%). Median overall survival after LITT for the total cohort was 11.5 mo, and median progression-free survival 6.6 mo.
CONCLUSION
LITT appears to be a safe and effective treatment for GBM in properly selected patients.
Graphical Abstract
Graphical Abstract
Video Abstract
10.1093/neuros/nyy375
Video Abstract
10.1093.neuros.nyy375
5821902691001
Publisher
Oxford University Press,Copyright by the Congress of Neurological Surgeons,Wolters Kluwer Health, Inc
Subject
/ Adult
/ Aged
/ Biopsy
/ Brain Neoplasms - diagnostic imaging
/ Edema
/ Female
/ Glioblastoma - diagnostic imaging
/ Gliomas
/ Humans
/ Hyperthermia, Induced - adverse effects
/ Hyperthermia, Induced - methods
/ Hyperthermia, Induced - mortality
/ Hyperthermia, Induced - statistics & numerical data
/ Lasers
/ Male
/ Medicine
/ NMR
/ Novels
/ Research—Human—Clinical Studies
/ Surgery
/ Tumors
