Format

Send to

Choose Destination
Neurosurgery. 2019 Apr 1;84(4):836-843. doi: 10.1093/neuros/nyy375.

Glioblastoma Treated With Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy: Safety, Efficacy, and Outcomes.

Kamath AA1, Friedman DD1, Akbari SHA1, Kim AH1,2,3,4, Tao Y5, Luo J5,6, Leuthardt EC1,4,7,8,9,10,11.

Author information

1
Departments of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri.
2
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.
3
Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri.
4
Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri.
5
Department of Biostatistics, Washington University School of Medicine, St. Louis, Missouri.
6
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
7
Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, Missouri.
8
Department of Mechanical Engineering and Materials Science, Washington University School of Medicine, St. Louis, Missouri.
9
Department of Neuroscience, Washington University School of Medicine, St. Louis, Missouri.
10
Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, Missouri.
11
Brain Laser Center, Washington University School of Medicine, St. Louis, Missouri.

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.

KEYWORDS:

Brain tumors; GBM; Glioblastoma; LITT; Laser ablation; Laser interstitial thermal therapy; MRI; Thermoablation

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center