Laser interstitial thermal therapy for newly diagnosed and recurrent glioblastoma.
OBJECTIVE Glioblastoma (GBM) is the most common and deadly malignant primary brain tumor. Better surgical therapies are needed for newly diagnosed GBMs that are difficult to resect and for GBMs that recur despite standard therapies. The authors reviewed their institutional experience of using laser interstitial thermal therapy (LITT) for the treatment of newly diagnosed or recurrent GBMs. METHODS This study reports on the pre-LITT characteristics and post-LITT outcomes of 8 patients with newly diagnosed GBMs and 13 patients with recurrent GBM who underwent LITT. RESULTS Compared with the group with recurrent GBMs, the patients with newly diagnosed GBMs who underwent LITT tended to be older (60.8 vs 48.9 years), harbored larger tumors (22.4 vs 14.6 cm3), and a greater proportion had IDH wild-type GBMs. In the newly diagnosed GBM group, the median progression-free survival and the median survival after the procedure were 2 months and 8 months, respectively, and no patient demonstrated radiographic shrinkage of the tumor on follow-up imaging. In the 13 patients with recurrent GBM, 5 demonstrated a response to LITT, with radiographic shrinkage of the tumor following ablation. The median progression-free survival was 5 months, and the median survival was greater than 7 months. CONCLUSIONS In carefully selected patients with recurrent GBM, LITT may be an effective alternative to surgery as a salvage treatment. Its role in the treatment of newly diagnosed unresectable GBMs is not established yet and requires further study.
Department of Neurosurgery, University of Texas MD Anderson Cancer Center; and.
Jonathan G
JG
Thomas
Department of Neurosurgery, University of Texas MD Anderson Cancer Center; and.
Ganesh
G
Rao
Department of Neurology, Houston Methodist Hospital, Houston, Texas.
Yvonne
Y
Kew
Department of Neurosurgery, University of Texas MD Anderson Cancer Center; and.
Sujit S
SS
Prabhu
D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D017567:Karnofsky Performance Status; D053685:Laser Therapy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies
CCNU = 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea; GBM; GBM = glioblastoma; KPS = Karnofsky Performance Scale; LITT; LITT = laser interstitial thermal therapy; NIH = National Institutes of Health; PFS = progression-free survival; RT = radiation therapy; TDT = thermal damage threshold; TMZ = temozolomide; glioblastoma; laser interstitial thermal therapy; recurrence