The role of laser interstitial thermal therapy in enhancing progression‐free survival of difficult‐to‐access high‐grade gliomas: a multicenter study

Mohammadi, Alireza; Hawasli, Ammar H.; Rodriguez, Analiz; Schroeder, Jason; Laxton, Adrian W.; Elson, Paul; Tatter, Stephen B.; Barnett, Gene H.; Leuthardt, Eric C.

doi:10.1002/cam4.266

Cited by 188 publications

(153 citation statements)

References 34 publications

(46 reference statements)

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“…Most recently, Mohammadi et al reported a 1-year estimated survival after LITT for mixed recurrent and newly diagnosed HGGs at 68% and overall progression-free survival at 5.1 months post-LITT. 44 Several authors have noted similar factors that contribute to better response to LITT. Consistent with traditional surgery, Mohammadi et al found that a greater extent of ablation (i.e., grosstotal ablation) increased progression-free survival from 4.6 to 9.7 months post-LITT.…”

Section: Clinical Outcomes After Treatment Of All Hggs With Stereotacmentioning

confidence: 95%

“…27 Mohammadi et al reported radiographic progression in 23 patients with 5 central, 12 peripheral, and 6 distant recurrences. 44 Hence, immediate radiographic analyses generally showed initial treatment effects including central tumor necrosis and peripheral enhancement. Despite reporting variability, several studies showed a reduction in HGG size, ranging from within days of LITT to within 33 months.…”

Section: Radiographic Outcomes After Treatment Of Hggs With Stereotacmentioning

confidence: 99%

“…Consistent with traditional surgery, Mohammadi et al found that a greater extent of ablation (i.e., grosstotal ablation) increased progression-free survival from 4.6 to 9.7 months post-LITT. 44 In addition to greater extent of ablation, higher-dose LITT may also be associated with improved radiographic responses and clinical outcomes. 27,41,67 Eleven studies reported a total of 52 complications, some more severe than others.…”

Section: Clinical Outcomes After Treatment Of All Hggs With Stereotacmentioning

confidence: 99%

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Stereotactic laser ablation of high-grade gliomas

Hawasli¹,

Kim

Dunn

et al. 2014

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107

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Evolving research has demonstrated that surgical cytoreduction of a high-grade glial neoplasm is an important factor in improving the prognosis of these difficult tumors. Recent advances in intraoperative imaging have spurred the use of stereotactic laser ablation (laser interstitial thermal therapy [LITT]) for intracranial lesions. Among other targets, laser ablation has been used in the focal treatment of high-grade gliomas (HGGs). The revived application of laser ablation for gliomas parallels major advancements in intraoperative adjuvants and groundbreaking molecular advances in neuro-oncology. The authors review the research on stereotactic LITT for the treatment of HGGs and provide a potential management algorithm for HGGs that incorporates LITT in clinical practice.

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Section: Clinical Outcomes After Treatment Of All Hggs With Stereotacmentioning

confidence: 95%

Section: Radiographic Outcomes After Treatment Of Hggs With Stereotacmentioning

confidence: 99%

Section: Clinical Outcomes After Treatment Of All Hggs With Stereotacmentioning

confidence: 99%

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Stereotactic laser ablation of high-grade gliomas

Hawasli¹,

Kim

Dunn

et al. 2014

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107

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“…This process has been demonstrated in animal models by increased locoregional passage of Evans blue dye and chemotherapy with agents such as paclitaxel. [2][3][4][5][6] However, at least anecdotally in several patients, we have noted the impact of cerebral edema following intervention with laser-induced thermal therapy for tumors (Neuroblate, Monteris Medical).…”

mentioning

confidence: 99%

Letter to the Editor: Stereotactic laser ablation of high-grade gliomas

Smith¹,

Salacz²,

Camarata³

2015

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“…6 Additionally, increasing the thermal dose appears to be associated with improved radiographic response and perhaps clinical outcome. 2,8 Intuitively, dose escalation with more aggressive laser ablation will increase the risk profile associated with LITT, particularly with the propensity for blood vessels and ventricles to act as heat sinks.…”

mentioning

confidence: 99%

Editorial: Laser interstitial thermal therapy: an effective treatment for focally recurrent high grade glioma

Malone

Bruce²

2014

FOC

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Laser interstitial thermal therapy (LITT) is an emerging treatment modality in glioma therapy. The technology is most effectively applied in the treatment of deep-seated lesions that are difficult to access surgically without injury to eloquent neurological structures. The LITT treatment produces focal thermal ablation leading to tumor cytoreduction through tissue coagulation, necrosis, and cellular apoptosis. Historically, laser ablation techniques have been limited by an inability to assess ablation progress and parenchymal temperature during the course of treatment. Advances in MRI capabilities have overcome these limitations, leading to the reapplication of this technology for select intracranial pathological entities, with promising preliminary results.In this issue of Neurosurgical Focus, Hawasli and colleagues review the current literature on LITT for the treatment of high-grade gliomas (HGGs).3 This report underscores the variability in published outcomes following LITT for HGG. Radiographically, the reported reduction in tumor size on follow-up imaging after LITT varies between 15% and 87% of total lesion volume.2,4 The average progression-free survival post-LITT ranges from 1 to 17 months, while overall survival post-LITT varies from 7 to 30 months.3 This variability may in part be attributed to mixed patient cohorts, including both newly diagnosed and recurrent tumors.Treatment results appear more consistent when limited to patients with disease recurrence, although this subgroup analysis is not available in all trials. Four studies that evaluated LITT as salvage therapy for recurrent HGG reported an overall survival of 9-15 months posttreatment. 1,5,7,8 Although these promising data are similar to survival achieved with salvage surgery for HGG, it is impossible to control for the contribution of adjuvant chemotherapies to this outcome. Nevertheless, recurrence may represent a favorable context for LITT application, because patients in this cohort are often poor surgical candidates with focal disease. Data from subgroup analysis of patients treated for newly diagnosed HGG are scarce. The varying indications that led to LITT as de novo treatment in these instances further limit conclusions that can be drawn from these data.Consistent with the surgical literature on extent of resection in HGG, "extent of ablation" appears to be an important factor influencing both overall and progressionfree survival.6 Additionally, increasing the thermal dose appears to be associated with improved radiographic response and perhaps clinical outcome.2,8 Intuitively, dose escalation with more aggressive laser ablation will increase the risk profile associated with LITT, particularly with the propensity for blood vessels and ventricles to act as heat sinks. Hawasli and colleagues report an overall complication rate of 49% after pooling data in their review of 174 HGG cases. Although some of these complications are minor and transient, there were 4 reports of cerebral edema, 30 of neurological deficits, and 6 reports of inf...

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The role of laser interstitial thermal therapy in enhancing progression‐free survival of difficult‐to‐access high‐grade gliomas: a multicenter study

Cited by 188 publications

References 34 publications

Stereotactic laser ablation of high-grade gliomas

Stereotactic laser ablation of high-grade gliomas

Letter to the Editor: Stereotactic laser ablation of high-grade gliomas

Editorial: Laser interstitial thermal therapy: an effective treatment for focally recurrent high grade glioma

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