Laser interstitial thermal therapy for brain metastases

Srinivasan, E.; Grabowski, Matthew M.; Nahed, Brian V.; Barnett, Gene H.; Fecci, Peter E.

doi:10.1093/noajnl/vdab128

Cited by 12 publications

(8 citation statements)

References 55 publications

(74 reference statements)

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“…[ 8 , 17 ] Biopsy and LITT can be performed through the same trajectory during a single case, making the paradigm extremely useful for identification of radiation necrosis versus recurrent disease in previously-irradiated tumors. [ 21 ] In other tumor types, LITT has been shown to be comparable to open resection in terms of care utilization and costs. [ 8 ] It should be noted that tumors are typically selected for LITT based in part on diameter <3 cm, due to risk of symptomatic post-LITT edema.…”

Section: Discussionmentioning

confidence: 99%

Laser ablation of a sphenoid wing meningioma: A case report and review of the literature

Haskell-Mendoza

Srinivasan

Suarez

et al. 2023

Surgical Neurology International

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Background: Meningiomas are the most common primary central nervous system neoplasm in the United States. While the majority of meningiomas are benign, the World Health Organization (WHO) Grade I tumors, a not-insignificant proportion of tumors are in anatomically complex locations or demonstrate more aggressive phenotypes, presenting a challenge for local disease control with surgery and radiation. Laser interstitial thermal therapy (LITT) consists of stereotactic delivery of laser light for tumor ablation and is minimally invasive, requiring implantation of a laser fiber through a cranial burr hole. Herein, we demonstrate the first use of this technology in a progressive atypical sphenoid wing meningioma for a previously resected and irradiated tumor. Case Description: A 47-year-old female was diagnosed with a left-sided atypical meningioma, the WHO 2, of the sphenoid wing following acute worsening of bitemporal headache and dizziness. Given neurovascular involvement, a subtotal resection was performed, followed by stereotactic radiosurgery. Following progression 9 months from resection, the patient elected to proceed with LITT. The patient’s postoperative course was uncomplicated and she remains progression free at 24 months following LITT. Conclusion: We present the first use of LITT for a sphenoid wing meningioma documented in the literature, which demonstrated enhanced disease control for a lesion that was refractory to both surgery and radiation. LITT could represent an additional option for local control of progressive meningiomas, even in locations that are challenging to access surgically. More evidence is needed regarding the technical nuances of LITT for lesions of the skull base.

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Section: Discussionmentioning

confidence: 99%

Laser ablation of a sphenoid wing meningioma: A case report and review of the literature

Haskell-Mendoza

Srinivasan

Suarez

et al. 2023

Surgical Neurology International

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“…B. für Trastuzumab-Deruxtecan bei aktiver Hirnmetastasierung auch nach multiplen zielgerichteten Vortherapien sehr ermutigende Wirksamkeitsdaten [125]. Lokaltherapeutisch ist die Einführung der laserinduzierten Thermotherapie (LITT) als vielversprechende minimal-invasive Behandlungsoption gerade bei mikrochirurgisch nicht zu erreichenden oder bereits bestrahlten Tumoren zu nennen [126]. Dies bedarf aber einer weiteren systematischen Evaluation in klinischen Studien.…”

Section: Perspektiven In Behandlung Von Zerebralen Metastasenunclassified

Hirnmetastasen

Schulz,

Proescholdt,

Schmidt

et al. 2024

Pneumologie

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ZusammenfassungZerebrale Metastasen bei Patienten mit Lungenkarzinom im Stadium der Metastasierung finden sich bereits bei mehr als 30% Patienten zum Zeitpunkt der Erstdiagnose und manifestieren sich im Verlauf der Erkrankung bei 2 von 3 Patienten. Die zerebrale Krankheitsmanifestation wurde lange Zeit als prognostisch ungünstig eingestuft. Betroffene Patienten wurden regelhaft von Therapiestudien unter Berücksichtigung der ungünstigen Prognose ausgeschlossen. Im Kontext zielgerichteter molekularer Therapiestrategien und etablierter immunonkologischer Systemtherapien stellt die Blut-Hirn-Schranke mittlerweile keine unüberwindbare Barriere mehr dar. Die Therapie von Hirnmetastasen erfordert aber stets die Betreuung in einem interdisziplinären Team und muss als Zentrumsaufgabe angesehen werden. Unter Berücksichtigung von Anzahl, Größe und Lokalisation der Hirnmetastasen, Neurologie und Allgemeinzustand, Komorbiditäten, potenzieller Lebenserwartung und Wunsch des Patienten, aber auch Tumorbiologie inklusive molekularer Veränderungen, extrakranieller Tumorlast und Verfügbarkeit einer ZNS-wirksamen Therapie erfolgt die differenzierte Therapieentscheidung. Hierbei werden mittlerweile häufig Systemtherapien sowie lokale neurochirurgische und strahlentherapeutische Therapiekonzepte kombiniert im Sinne optimierter und prognoseverbessernder Therapiestrategien.

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“…LITT is a relatively new procedure, and guidelines, which vary depending on the institution and the specific case, are still evolving [86][87][88][89][90][91][92][93][94]. Table 4 summarizes some guidelines for LITT.…”

Section: Indications For Littmentioning

confidence: 99%

“…Pediatric Low-Grade Gliomas Recurrent or residual tumors that are not amenable to resection or conventional radiation therapy. [86,87] Newly diagnosed tumor that is not surgically accessible. [88] Adult Low-Grade Gliomas Small or deep-seated tumors that are not amenable to resection or as an adjunct to surgical resection to improve the extent of resection.…”

Section: Patient Age and Glioma Grade Indications For Litt Referencesmentioning

confidence: 99%

Advancements in Glioma Care: Focus on Emerging Neurosurgical Techniques

De Simone,

Conti,

Palermo

et al. 2023

Biomedicines

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Background: Despite significant advances in understanding the molecular pathways of glioma, translating this knowledge into effective long-term solutions remains a challenge. Indeed, gliomas pose a significant challenge to neurosurgical oncology because of their diverse histopathological features, genetic heterogeneity, and clinical manifestations. Relevant sections: This study focuses on glioma complexity by reviewing recent advances in their management, also considering new classification systems and emerging neurosurgical techniques. To bridge the gap between new neurosurgical approaches and standards of care, the importance of molecular diagnosis and the use of techniques such as laser interstitial thermal therapy (LITT) and focused ultrasound (FUS) are emphasized, exploring how the integration of molecular knowledge with emerging neurosurgical approaches can personalize and improve the treatment of gliomas. Conclusions: The choice between LITT and FUS should be tailored to each case, considering factors such as tumor characteristics and patient health. LITT is favored for larger, complex tumors, while FUS is standard for smaller, deep-seated ones. Both techniques are equally effective for small and superficial tumors. Our study provides clear guidance for treating pediatric low-grade gliomas and highlights the crucial roles of LITT and FUS in managing high-grade gliomas in adults. This research sets the stage for improved patient care and future developments in the field of neurosurgery.

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Laser interstitial thermal therapy for brain metastases

Cited by 12 publications

References 55 publications

Laser ablation of a sphenoid wing meningioma: A case report and review of the literature

Laser ablation of a sphenoid wing meningioma: A case report and review of the literature

Hirnmetastasen

Advancements in Glioma Care: Focus on Emerging Neurosurgical Techniques

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