Laser interstitial thermal therapy as an adjunct therapy in brain tumors: A meta-analysis and comparison with stereotactic radiotherapy

Abstract

Background: Minimally invasive procedures are gaining widespread acceptance in difficult-to-access brain tumor treatment. Stereotactic radiosurgery (SRS) is the preferred choice, however, laser interstitial thermal therapy (LITT) has emerged as a tumor cytoreduction technique. The present meta-analysis compared current SRS therapy with LITT in brain tumors. Methods: A search was performed in Lilacs, PubMed, and Cochrane database. Patient’s demographics, tumor location, therapy used, Karnofsky performance status score before treatment, and patient’s outcome (median overall survival, progression-free survival, and adverse events) data were extracted from studies. The risk of bias was assessed by Cochrane collaboration tool. Results: Twenty-five studies were included in this meta-analysis. LITT and SRS MOS in brain metastasis patients were 12.8 months’ versus 9.8 months (ranges 9.3–16.3 and 8.3–9.8; P = 0.02), respectively. In a combined comparison of adverse effects among LITT versus SRS in brain metastasis, we found 15% reduction in absolute risk difference (−0.16; 95% confidence interval P < 0.0001). Conclusion: We could not state that LITT treatment is an optimal alternative therapy for difficult-to-access brain tumors due to the lack of systematic data that were reported in our pooled studies. However, our results identified a positive effect in lowering the absolute risk of adverse events compared with SRS therapy. Therefore, randomized trials are encouraged to ascertain LITT role, as upfront or postoperative/post-SRS therapy for brain tumor treatment.

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

“…These limitations have been reported in multiple studies, emphasizing the critical need for more extensive, well-designed studies incorporating control groups to provide more conclusive insights into the intricate relationship between LITT and wound complications in brain tumour patients. [32][33][34][35] F I G U R E 4 Subsequent binary outcome meta-analysis of wound incidences. (A) Forest Plot.…”

“…Moreover, the comparatively smaller sample sizes and varied patient demographics in different studies could have impacted the observed heterogeneity and effect sizes. These limitations have been reported in multiple studies, emphasizing the critical need for more extensive, well‐designed studies incorporating control groups to provide more conclusive insights into the intricate relationship between LITT and wound complications in brain tumour patients 32–35 …”

Developments in Brain Tumor Segmentation Using MRI: Deep Learning Insights and Future Perspectives

“…In the form of image-guided surgery (IGS), stereotactic surgery uses several imaging modalities, including CT and MRI, to produce a precise map of the brain [142] [143]. The surgeon then used this map to precisely direct a surgical tool, such as a drill or biopsy needle, to the tumor's position.…”