Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN): 12-Month Outcomes and Quality of Life After Brain Tumor Ablation

Kim, Albert H.; Tatter, Steven; Rao, Ganesh; Prabhu, Sujit S.; Chen, Clark; Fecci, Peter E.; Chiang, Veronica; Smith, Kris A.; Williams, Brian J.; Mohammadi, Alireza; Judy, Kevin; Sloan, Andrew E.; Tovar-Spinoza, Zulma; Baumgartner, James; Hadjipanayis, Constantinos; Leuthardt, Eric C.

doi:10.1093/neuros/nyaa071

Cited by 53 publications

(41 citation statements)

References 49 publications

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“…Occasionally, GBM patients may not be candidates for surgical debulking of the tumor via an open craniotomy, and a relatively new technique known as ‘Laser Interstitial Thermal Therapy’ (LITT) is being trialed as a potential cytoreductive technique in destroying tumor cells via a localized elevated temperature [ 42 , 43 , 44 ]. It involves the insertion of an MRI-guided laser-tip probe into the tumor to deliver low-powered laser-induced thermotherapy.…”

Section: Therapeutic Strategies For Glioblastomamentioning

confidence: 99%

Novel Treatment Strategies for Glioblastoma

Stylli

2020

Cancers

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Glioblastoma (GBM) is the most common primary central nervous system tumor in adults. It is a highly invasive disease, making it difficult to achieve a complete surgical resection, resulting in poor prognosis with a median survival of 12–15 months after diagnosis, and less than 5% of patients survive more than 5 years. Surgical, instrument technology, diagnostic and radio/chemotherapeutic strategies have slowly evolved over time, but this has not translated into significant increases in patient survival. The current standard of care for GBM patients involving surgery, radiotherapy, and concomitant chemotherapy temozolomide (known as the Stupp protocol), has only provided a modest increase of 2.5 months in median survival, since the landmark publication in 2005. There has been considerable effort in recent years to increase our knowledge of the molecular landscape of GBM through advances in technology such as next-generation sequencing, which has led to the stratification of the disease into several genetic subtypes. Current treatments are far from satisfactory, and studies investigating acquired/inherent resistance to current therapies, restricted drug delivery, inter/intra-tumoral heterogeneity, drug repurposing and a tumor immune-evasive environment have been the focus of intense research over recent years. While the clinical advancement of GBM therapeutics has seen limited progression compared to other cancers, developments in novel treatment strategies that are being investigated are displaying encouraging signs for combating this disease. This aim of this editorial is to provide a brief overview of a select number of these novel therapeutic approaches.

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Section: Therapeutic Strategies For Glioblastomamentioning

confidence: 99%

Novel Treatment Strategies for Glioblastoma

Stylli

2020

Cancers

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“…Laser interstitial thermal therapy (LITT) has emerged as an alternative, minimal invasive neurosurgical technique for patients with epilepsy, tumors or radiation necrosis [ 1 ]. LITT has been proven to be useful for lesions located in difficult to access brain areas, in patients with a greater surgical risk or in the case of recurrence and repeated resections [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with unresectable glioblastoma could especially benefit from LITT, as LITT can be added to the standard adjuvant chemotherapy and radiotherapy to improve clinical outcomes. Previous studies have suggested that patients with nGBM have reasonable survival outcomes and complication rates when treated with LITT [ 1 , 2 , 3 , 4 , 5 , 7 , 9 , 10 ]. In addition, LITT is not bound to a maximum dose and can therefore be used multiple times [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Laser Interstitial Thermal Therapy in Patients with Newly Diagnosed Glioblastoma: A Systematic Review

Viozzi

Guberinic

Overduin

et al. 2021

JCM

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Background: Laser interstitial thermal therapy (LITT) is a minimal invasive neurosurgical technique for the treatment of brain tumors. Results of LITT have been reported in a case series of patients with deep seated and/or recurrent glioblastoma or cerebral metastases. With this review we aim to summarize the currently available evidence regarding safety and effectiveness of LITT in patients with newly diagnosed glioblastoma (nGBM). Methods: A literature search was performed using electronic databases (PubMed and Embase). Papers were assessed for the methodological quality using the Risk Of Bias In Non- randomised Studies - of Interventions (ROBINS-I) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Results: We identified 835 papers of which only 11 articles were eligible for our review. All papers suffered from serious or critical risk of bias, and the quality of evidence was graded as very low according to the GRADE criteria. None of the studies was randomized and reporting of confounders and other parameters was poor. Median overall survival (OS) ranged from 4.1 to 32 months and progression free survival (PFS) from 2 to 31 months. The mean complication rate was 33.7%. No quality of life or cost-effectiveness data were reported. Conclusions: Due to the low quality of the studies, it is not possible to draw firm conclusions regarding the (cost) effectiveness of LITT in patients with newly diagnosed glioblastoma. The low quality of evidence shows the need for a well-designed prospective multicenter randomized controlled trial.

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“…In a recent publication looking at outcome, 83.2% of patients were able to be discharged home after hospital stay of a mean of only 33.8 h and with a only 1.5% rate of serious adverse events or repeat hospitalization within 30 days of the procedure. [ 22 ] Longest length of hospital stay in this same study, however, was 29 days. Studies have shown that LITT treatment of deep-seated gliomas led to longer intensive care unit stays for delayed neurological recovery.…”

Section: Mrglitt For Malignant Tumorsmentioning

confidence: 60%

Laser interstitial thermal therapy in neuro-oncology applications

Hong¹,

Kundishora²,

Elsamadicy³

et al. 2020

Surgical Neurology International

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Background: Laser interstitial thermal therapy (LITT) is a minimally invasive surgical treatment for multiple intracranial pathologies that are of growing interest to neurosurgeons and their patients and is emerging as an effective alternative to standard of care open surgery in the neurosurgical armamentarium. This option was initially considered for those patients with medical comorbidities and lesion-specific characteristics that confer excessively high risk for resection through a standard craniotomy approach but indications are changing. Methods: The PubMed database was searched for studies in the English literature on LITT for the treatment of primary and metastatic brain tumors, meningiomas, as well as for radiation necrosis (RN) in previously irradiated brain tumors. Results: This review provides an update of the relevant literature regarding application of LITT in neurosurgical oncology for the treatment of de novo and recurrent primary gliomas and brain metastases radiographically regrowing after previous irradiation as recurrent tumor or RN. In addition, this review details the limited experience of LITT with meningiomas and symptomatic peritumoral edema after radiosurgery. The advantages and disadvantages, indications, and comparisons to standard of care treatments such as craniotomy for open surgical resection are discussed for each pathology. Finally, the literature on cost-benefit analyses for LITT are reviewed. Conclusion: The studies discussed in this review have helped define the role of LITT in neurosurgical oncology and delineate optimal patient selection and tumor characteristics most suitable to this intervention.

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Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN): 12-Month Outcomes and Quality of Life After Brain Tumor Ablation

Cited by 53 publications

References 49 publications

Novel Treatment Strategies for Glioblastoma

Novel Treatment Strategies for Glioblastoma

Laser Interstitial Thermal Therapy in Patients with Newly Diagnosed Glioblastoma: A Systematic Review

Laser interstitial thermal therapy in neuro-oncology applications

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