title: Stereotactic Laser Interstitial Thermal Therapy for Recurrent High-Grade Gliomas.
abstract: BACKGROUND
  The value of maximal safe cytoreductive surgery in recurrent high-grade gliomas (HGGs) is gaining wider acceptance. However, patients may harbor recurrent tumors that may be difficult to access with open surgery. Laser interstitial thermal therapy (LITT) is emerging as a technique for treating a variety of brain pathologies, including primary and metastatic tumors, radiation necrosis, and epilepsy.
  
  
  OBJECTIVE
  To review the role of LITT in the treatment of recurrent HGGs, for which current treatments have limited efficacy, and to discuss the possible role of LITT in the disruption of the blood-brain barrier to increase delivery of chemotherapy locoregionally.
  
  
  METHODS
  A MEDLINE search was performed to identify 17 articles potentially appropriate for review. Of these 17, 6 reported currently commercially available systems and as well as magnetic resonance thermometry to monitor the ablation and, thus, were thought to be most appropriate for this review. These studies were then reviewed for complications associated with LITT. Ablation volume, tumor coverage, and treatment times were also reviewed.
  
  
  RESULTS
  Sixty-four lesions in 63 patients with recurrent HGGs were treated with LITT. Frontal (n = 34), temporal (n = 14), and parietal (n = 16) were the most common locations. Permanent neurological deficits were seen in 7 patients (12%), vascular injuries occurred in 2 patients (3%), and wound infection was observed in 1 patient (2%). Ablation coverage of the lesions ranged from 78% to 100%.
  
  
  CONCLUSIONS
  Although experience using LITT for recurrent HGGs is growing, current evidence is insufficient to offer a recommendation about its role in the treatment paradigm for recurrent HGGs.
  
  
  BACKGROUND
  BBB, blood-brain barrierFDA, US Food and Drug AdministrationGBM, glioblastoma multiformeHGG, high-grade gliomaLITT, laser interstitial thermal therapy.
authors.affiliation: *Hermelin Brain Tumor Center, Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan; ‡Department of Neurosurgery, Mt. Sinai Beth Israel Hospital, New York City, New York.
authors.forename: Ian
authors.initials: I
authors.lastname: Lee
authors.forename: Steven
authors.initials: S
authors.lastname: Kalkanis
authors.forename: Constantinos G
authors.initials: CG
authors.lastname: Hadjipanayis
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D065426:Cytoreduction Surgical Procedures / Q000379:methods; D005909:Glioblastoma / Q000601:surgery; D005910:Glioma / Q000601:surgery*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D053685:Laser Therapy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D013238:Stereotaxic Techniques