Laser Ablation of Newly Diagnosed Malignant Gliomas

Ivan, Michael E.; Mohammadi, Alireza; Deugd, Nicoleta De; Reyes, Joshua; Rodriguez, Gregor A.; Shah, Ashish H.; Barnett, Gene H.; Komotar, Ricardo J.

doi:10.1227/neu.0000000000001446

Cited by 58 publications

(47 citation statements)

References 33 publications

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“…Different methods of hyperthermia treatment for brain tumors are being actively investigated, including the use of magnetic nanoparticles [27,28] and laser for thermal ablation [29]. Our hyperthermia device avoids direct injury to the surrounding normal brain tissues which may be a problem when directly ablating the tumor with a laser.…”

Section: Discussionmentioning

confidence: 99%

Local recurrence of brain metastasis reduced by intra-operative hyperthermia treatment

Byun

Gwak

Kwon

et al. 2018

International Journal of Hyperthermia

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Purpose: Brain metastasis is a common complication in cancer patients. Local recurrence after total resection of metastatic brain tumor has been frequently reported. In this study, we developed a new hyperthermia device and applied it to metastatic brain tumor patients intra-operatively to study if hyperthermia treatment could reduce local tumor recurrence. Materials and methods: A total of 63 metastatic brain patients were enrolled in the study with an informed consent obtained from every patient. After total resection of the tumor, the hyperthermia device was applied intra-operatively to the resection cavity. The surrounding brain tissue at 5 mm in depth from the tumor resection margin was raised to 42.5 C for a total of 60 minutes (Clinical Research Information Service Registration Number: KCT0001308). Results: A total of 10 local recurrences were observed in 63 patients who received hyperthermia treatment showing a local recurrence rate of 15.8%. It was significantly lower than the local recurrence rate of those who received conventional treatment (34%) when analyzed with one tailed z-test (p value: .001). Kaplan-Meier analysis also showed a significantly lower recurrence rate in the hyperthermia treatment group (p value: .0003). Complications included two cases of seizures and two cases of wound infection. Conclusions: Results of this study suggest that intra-operative hyperthermia treatment after total resection of metastatic brain tumor could reduce local recurrence of tumor. We believe that intraoperative hyperthermia treatment could be used as an adjuvant therapy to surgery and post-operative radiotherapy, or as a salvage treatment in patients who cannot receive further radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Local recurrence of brain metastasis reduced by intra-operative hyperthermia treatment

Byun

Gwak

Kwon

et al. 2018

International Journal of Hyperthermia

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“…Although GBM is a diffusely infiltrative disease, gross total resection (GTR) is associated with increased progression-free survival and overall survival compared to subtotal resection (STR), which itself confers a survival benefit compared to biopsy alone [7]. Studies aiming to quantify a threshold extent of resection have concluded that a threshold at 78% resection of radiographic tumor is necessary to confer a survival benefit compared to radiation and chemotherapy alone [8][9][10][11]. Other recent studies have found an additional survival benefit from supra-total resection (i.e., resection beyond the contrast-enhancing tumor margins) to include any fluid-attenuated inversion recovery (FLAIR) abnormalities or a total right frontal or parietal lobectomy compared to GTR [12,13].…”

Section: Rationale For Use Of Litt For Glioblastomamentioning

confidence: 99%

“…Both systems have a computer workstation with software for MR thermal imaging analysis and control over laser treatment parameters [25]. The 1064 nm wavelength laser used in the NeuroBlate system allows for deeper tissue penetration and potentially larger ablation zone, while the Visualase 980 nm wavelength laser produces more efficient heating [9].…”

Section: Litt System Platformsmentioning

confidence: 99%

“…The surgeon can reasonably predict to achieve an extent of ablation of at least 80%. This threshold is generalized from previous studies of the extent of tumor resection necessary to confer a significant survival benefit in open surgical resection [8][9][10][11]. Therefore, LITT offers a minimally invasive cytoreductive therapy for patients with surgically inaccessible or treatment refractory tumors who would not benefit more from open surgical resection.…”

Section: Criteria For Patient Selectionmentioning

confidence: 99%

“…3. The use of non-ionizing radiation: unlike ionizing radiation therapy, LITT thermal therapy can be used repeatedly without the risk of radiation necrosis [9]. Moreover, LITT can be used as a salvage therapy in treatment refractory tumors and may avoid increased risk of secondary malignancy-associated ionizing radiation [18].…”

Section: Current Role Of Litt In Neurosurgerymentioning

confidence: 99%

See 2 more Smart Citations

Laser Ablation for Gliomas

Semonche¹,

Eichberg²,

Shah³

et al. 2020

Brain and Spinal Tumors - Primary and Secondary

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Laser interstitial thermal therapy (LITT) is a novel minimally invasive neurosurgical procedure in which laser light is delivered through a stereotactically positioned probe to an intracranial lesion for controlled thermal ablation of the pathological tissue. LITT is considered for patients who are poor candidates for open surgical resection due to (1) location of lesion (e.g., deep-seated or near critical structures), (2) history of intracranial interventions or medical comorbidities that increase surgical risk, or (3) lesion refractoriness to prior conventional therapies. The use of LITT was initially limited by concerns over off-target thermal damage; however, recent advances in magnetic resonance imaging-based thermal imaging have enabled real-time monitoring of tissue ablation dynamics, thereby improving its safety profile. Accordingly, the past two decades have seen a rapid expansion in the use of LITT for a variety of intracranial pathologies, including neoplasms, radiation necrosis, and epilepsy. This chapter focuses on the novel application of LITT to both newly diagnosed and recurrent glioblastoma multiforme (GBM). We first review the technological developments that enabled the safe use of LITT for GBM. We then review recent evidence regarding the indications, outcomes, and limitations of LITT as a novel adjuvant treatment for GBM.

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