• Neurosurgery · Aug 2020

    The Role of Laser Interstitial Thermal Therapy in Surgical Neuro-Oncology: Series of 100 Consecutive Patients.

    • Ashish H Shah, Alexa Semonche, Daniel G Eichberg, Veronica Borowy, Evan Luther, Christopher A Sarkiss, Alexis Morell, Anil K Mahavadi, Michael E Ivan, and Ricardo J Komotar.
    • Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, Florida.
    • Neurosurgery. 2020 Aug 1; 87 (2): 266-275.

    BackgroundLaser interstitial thermal therapy (LITT) is an adjuvant treatment for intracranial lesions that are treatment refractory or in deep or eloquent brain. Initial studies of LITT in surgical neuro-oncology are limited in size and follow-up.ObjectiveTo present our series of LITT in surgical neuro-oncology to better evaluate procedural safety and outcomes.MethodsAn exploratory cohort study of all patients receiving LITT for brain tumors by a single senior neurosurgeon at a single center between 2013 and 2018. Primary outcomes included extent of ablation (EOA), time to recurrence (TTR), local control at 1-yr follow-up, and overall survival (OS). Secondary outcomes included complication rate. Outcomes were compared by tumor subtype. Predictors of outcomes were identified.ResultsA total of 91 patients underwent 100 LITT procedures; 61% remain alive with 72% local control at median 7.2 mo follow-up. Median TTR and OS were 31.9 and 16.9 mo, respectively. For lesion subtypes, median TTR (months, not applicable [N/A] if <50% rate observed), local control rates at 1-yr follow-up, and median OS (months) were the following: dural-based lesions (n = 4, N/A, 75%, 20.7), metastases (n = 45, 55.9, 77.4%, 16.9), newly diagnosed glioblastoma (n = 11, 31.9, 83.3%, 32.3), recurrent glioblastoma (n = 14, 5.6, 24.3%, 7.3), radiation necrosis (n = 20, N/A, 67.2%, 16.4), and other lesions (n = 6, 12.3, 80%, 24.4). TTR differed by tumor subtype (P = .02, log-rank analysis). EOA predicted local control (P = .009, multivariate proportional hazards regression); EOA > 85% predicted longer TTR (P = .006, log-rank analysis). Complication rate was 4%.ConclusionOur series of LITT in surgical neuro-oncology, 1 of the largest to date, further evidences its safety and outcomes profile.Copyright © 2019 by the Congress of Neurological Surgeons.

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