Image-guided resection of glioblastoma in eloquent brain areas facilitated by laser surface thermal therapy: clinical outcomes and long-term results.

Abstract

The increased interest in the application of lasers in neuro-oncology prompted us to present our experience of using the laser technologies in the treatment of cerebral gliomas. The aim of the study was to evaluate the clinical efficacy of image-guided laser surface thermal therapy (LSTT) and its influence on survival of patients with glioblastoma (GBM).Data of 91 patients (49 males, 42 females, mean age 51.4years, range 23-70years) with supratentorial GBMs located in close vicinity to or within the eloquent brain areas were retrospectively analyzed.All patients were divided into two groups: LSTT group (n = 28) and control group (n = 63). There were no significant differences by gender, age, Karnofsky Performance Scale (KPS) score, and tumor location between groups. Total removal in the LSTT group was performed in 67.9%, in the control group-31.7% (p < 0.01); on the contrary, subtotal removal prevailed in the control group-52.4%; in the LSTT group, it was 32.1%. In postoperative period, there was no significant difference in KPS score between the groups (p = 0.89). A higher degree of resection provided an increase in survival rates (p < 0.01). The median overall survival was 15.5 ± 10.5months, in the LSTT group 18.4 ± 11.7 and in the control group 14.3 ± 9.1 (p = 0.03). The application of image-guided LSTT in patients with GBMs of eloquent brain areas allowed the high rate of complete resection and improved overall survival without the negative effect on the functional status after surgery.