[Stereotaxic laser interstitial thermotherapy. A new alternative in the therapeutic management of some brain tumors].
Laser Interstitial Thermo Therapy (ITT) is a new procedure which has been performed only a few times in our department as well as in foreign services. The aim of an ITT is to increase the temperature of a tumoral target which has been perfectly determined stereotactically. In the center of the target, i-e at the extremity of the laser fibre, temperature reaches 80 degrees 90 degrees C and creates a coagulation necrosis. At the periphery of the target, temperature must be 41 degrees-43 degrees C so as to create a selective lesion of the pathological tissue due to proteinic and enzymatic denaturation. The authors present their experience based on 8 patients who underwent an ITT between June 1990 and October 1991. A stereotactic determination of the tumor is first performed; then two routes are determined for the laser-fibre (Nd-YAG 1.06 microns, fiber diameter: 400 mu) and for the thermic electrode. The ITT itself is performed a few days later (P = 3-5w, time: 800-1200 seconds). Laser heat effects are monitored with MRI controls (H5, H24, D8 then monthly). The authors insist on the importance of a long follow-up so as to be sure of the complete inocuity of such a treatment. It is the only way to broaden and develop laser-ITT procedures as therapeutic alternatives for certain deep-seated intracerebral tumors.
Roux
F X
FX
Centre Hospitalier Sainte-Anne, Service de neurochirurgie, Paris.
Merienne
L
L
Fallet-Bianco
C
C
Beuvon
F
F
Devaux
B
B
Leriche
B
B
Cioloca
C
C
D001932:Brain Neoplasms / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000628:therapy; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007834:Lasers; D008297:Male; D010911:Pituitary Neoplasms / Q000628:therapy; D013238:Stereotaxic Techniques
La thermothérapie interstitielle laser stéréotaxique. Une nouvelle alternative dans la prise en charge thérapeutique de certaines tumeurs cérébrales.