Current role of laser interstitial thermal therapy in the treatment of intracranial tumors

Abstract

Laser interstitial thermal therapy (LITT) is gaining popularity in the treatment of both primary and secondary intracranial tumors. The goal of LITT is to deliver thermal energy in a predictable, controlled, and minimally invasive fashion. It can be particularly valuable in patients with recurrent tumors who, due to previous radiation or surgery, may have a potentially higher risk of wound breakdown or infection with repeat craniotomy. Deep-seated lesions that are often inaccessible through open approaches (thalamus, hypothalamus, mesial basal temporal lobe, brainstem) may also be suitable targets. The experience and data published thus far on this modality is limited but growing. This review highlights the use of LITT as a primary treatment method in a variety of intracranial tumors, as well as its application as an adjunct to established surgical techniques.

Meta‐analysis of the impact of laser interstitial hyperthermia on wound healing complications in brain tumors

“…Laser interstitial hyperthermia therapy has shown great potential as a viable treatment option for patients who are prone to or currently experiencing wound complications resulting from previous treatments, based on various research studies. The cumulative evidence indicates that patients who have experienced previous wound complications or are at an elevated risk of impaired wound healing or wound dehiscence may avoid further worse complications by undergoing LITT 2,7,9,11,24–31 . Several studies have shown that patients undergoing LITT after experiencing previous complications have significantly fewer wound complications (1%–10%) than other treatment options 7,10,11,15–17 .…”

“…The cumulative evidence indicates that patients who have experienced previous wound complications or are at an elevated risk of impaired wound healing or wound dehiscence may avoid further worse complications by undergoing LITT. 2 , 7 , 9 , 11 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 Several studies have shown that patients undergoing LITT after experiencing previous complications have significantly fewer wound complications (1%–10%) than other treatment options. 7 , 10 , 11 , 15 , 16 , 17 While a few individuals reported only a few instances of wound complications following LITT, others stated that there were no reported occurrences of wound complications at all.…”

“…Over the years, LITT has witnessed a resurgence in popularity, attributed to technological advancements that address its initial constraints. The thermal therapy is designed to administer precise and predictable thermal energy, which is especially beneficial for treating difficult‐to‐reach deep‐seated lesions that cannot be accessed through conventional open craniotomies 2 . The inclusion of magnetic resonance thermography (MRT) permits instantaneous visualization, facilitating precise heating of specific tissues while minimizing harm to adjacent normal tissue.…”

Safety and Efficacy of Laser Interstitial Thermal Therapy as Upfront Therapy in Primary Glioblastoma and IDH-Mutant Astrocytoma: A Meta-Analysis

“…To the best of our knowledge, this is the first meta-analysis since the 2021 WHO CNS5 guidelines to evaluate the outcomes of LITT as initial therapy in both primary IDH-wildtype GBM and IDH-mutant astrocytoma. Currently, LITT is often used in cases of deep-seated lesions, when there are contraindications to radiotherapy or resection, proximity to eloquent regions, or in cases where patients are particularly vulnerable to wound complications [ 70 , 71 , 72 ]. In the past, LITT has been shown to reduce postoperative complications while maintaining high ablation rates [ 69 , 73 ].…”

Surgical treatment of solitare brain metastases

“…Несмотря на то что теоретическая основа метода разработана в 70-е годы XX века, наиболее крупные серии наблюдений к 2015 г. насчитывали до 20 пациентов. На сегодняшний день этот метод служит дополнительной опцией, применение которой возможно в сочетании с хирургическим лечением, ЛТ и ХТ, но не в качестве самостоятельного метода лечения [26]. Показания к применению методики, по данным литературы, -первичные и рецидивные ЦМ глубинной локализации диаметром 1-3 см, а также ЦМ, не чувствительные к ЛТ [7].…”