• Neurosurgery · Dec 2016

    Review Meta Analysis

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

    • Michael E Ivan, Alireza M Mohammadi, Nicoleta De Deugd, Joshua Reyes, Gregor Rodriguez, Ashish Shah, Gene H Barnett, and Ricardo J Komotar.
    • *Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, The University of Miami Miller School of Medicine, Miami, Florida; ‡The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurological Surgery, Neurological and Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
    • Neurosurgery. 2016 Dec 1; 79 Suppl 1: S17-S23.

    BackgroundMagnetic 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.ObjectiveIn this analysis, we investigate initial data on the use of MR-LITT in the treatment of newly diagnosed high-grade gliomas.MethodsWith 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.ResultsTwenty-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.ConclusionMR-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.AbbreviationsBBB, blood-brain barrierHGG, high-grade gliomaLITT, laser-interstitial thermal therapyWHO, World Health Organization.

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