Laser Ablation of Newly Diagnosed Malignant Gliomas: a Meta-Analysis.

Abstract

BACKGROUND:

Magnetic resonance-guided laser-interstitial thermotherapy (MR-LITT) is a minimally invasive technique that shows promise in neuro-oncology because of its superiority in delivering precise minimally invasive thermal energy with minimal collateral damage.

OBJECTIVE:

In this analysis, we investigate initial data on the use of MR-LITT in the treatment of newly diagnosed high-grade gliomas.

METHODS:

With the use of the PubMed, OVID, and Google-scholar database systems, a comprehensive search of the English literature was performed. Eighty-five articles were identified plus 1 that is pending publication. Four articles were accounted for in this review, including 25 patients with newly diagnosed high-grade gliomas who underwent MR-LITT treatment. We evaluated safety, progression-free survival, and overall survival.

RESULTS:

Twenty-five patients with a mean age of 53.8 years underwent LITT treatments. On average, 82.9% of the pretreatment lesion volume was ablated. The average tumor volume treated was 16.5 cm. The mean follow-up time was 7.6 months. Median overall survival was found to be 14.2 months (range 0.1-23 months). The median progression-free survival was 5.1 months (range 2.4-23 months); however, these data are limited by the relatively short follow-up of the patients reviewed and small sample size of only 25 patients. There was 1 (3.4%) major perioperative complication, which was a central nervous system infection.

CONCLUSION:

MR-LITT is a promising technology for the treatment of small, yet difficult-to-treat newly diagnosed high-grade gliomas. This study demonstrates that MR-LITT is safe, and future randomized studies are needed to evaluate its role as a treatment adjunct for newly diagnosed high-grade gliomas.

ABBREVIATIONS:

BBB, blood-brain barrierHGG, high-grade gliomaLITT, laser-interstitial thermal therapyWHO, World Health Organization.

• Authors: Michael E Ivan, Alireza M Mohammadi, Nicoleta De Deugd, Joshua Reyes, Gregor Rodriguez, Ashish Shah, Gene H Barnett, Ricardo J Komotar
• Journal: Neurosurgery (Neurosurgery) Vol. 79 Suppl 1 Pg. S17-S23 (Dec 2016) ISSN: 1524-4040 [Electronic] United States
• PMID: 27861322 (Publication Type: Journal Article, Meta-Analysis, Review)

Topics

• Brain Neoplasms (surgery)
• Disease-Free Survival
• Glioma (surgery)
• Humans
• Hyperthermia, Induced (methods)
• Laser Therapy (adverse effects, methods)
• Magnetic Resonance Imaging, Interventional
• Survival Analysis