Delayed Failure of Laser-Induced Interstitial Thermotherapy for Postradiosurgery Brain Metastases

Abstract

Surgical resection has been shown to prolong survival in patients with glioblastoma multiforme (GBM), although this benefit has not been demonstrated for reoperation following tumor recurrence. Laser interstitial thermal therapy (LITT) is a minimally invasive ablation technique that has been shown to effectively reduce tumor burden in some patients with intracranial malignancy. The aim of this study was to describe the safety and efficacy of LITT for recurrent and newly diagnosed GBM at a large tertiary referral center.Patients with GBM receiving LITT were retrospectively analyzed. Overall survival from the time of LITT was the primary end point measured.There were 69 patients identified for inclusion in this study. The median age of the cohort was 56 years (range, 15–77 years). Median tumor volume was 10.4 cm3 (range, 1.0–64.0 cm3). A Kaplan-Meier estimate of median overall survival for the series from the time of LITT was 12 months (95% confidence interval 8–16 months). Median progression-free survival for the cohort from LITT was 4 months (95% confidence interval 3–7 months). Adjuvant chemotherapy significantly prolonged progression-free survival and overall survival (P < 0.01 for both) in the cohort. Gross total ablation was not significantly associated with progression-free survival (P = 0.09).LITT can safely reduce intracranial tumor burden in patients with GBM who have exhausted other adjuvant therapies or are poor candidates for conventional resection techniques.