Targeted Cryosurgery for the Treatment of Cerebral Glioma with Cryocare Surgical System Guided by Stereotactic Technology

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This study is to investigate the therapeutic effects of cryoablation guided by stereotactic technology for targeted cryosurgery of patients with cerebral glioma. The Cosman-Roberts-Wells (CRW) stereotactic apparatus and brain CT (Computed tomography) scan were applied to define the coordinates of the center and marginal points of the glioma. Twelve cases with recurrent glioma were treated by freezing-re-warming-freezing therapy in designated targets with cryocare surgical system's therapeutic probes. One patient, whose temporal tumor was 3.5cm in diameter, underwent drilling-hole cryoablation without resection in the central target of the tumor; the other eleven patients, whose maximum diameters of frontal and occipitoparietal tumors were between 4.5–9cm, underwent stereotactic volumetric resection and the frozen tumor tissues were removed after intraoperative freezing. Postoperative CT scans indicated that glioma tissues and regions 1cm surrounding the tumors in the eleven cases were excised, and no postoperative hemorrhage or remarkable edema was noted; staining of lesions in the case undergoing direct cryosurgery vanished in reexamination two weeks after the treatment, CT density declined and lesions had a tendency to become malacic. One case whose hemiparesis aggravated after operation recovered after symptomatic treatment and one case with poor prognostic scalp incision recovered after scalp flap transposition. The average follow-up duration was 2.6 years in the eleven cases. Eight cases with astrocytic glioma survived, among which three cases recurred and five did not. One case with astrocytic glioma died 1.5 years later and one died 2 years later. The patient with glioblastoma died after 1.2 years. Stereotaxy-guided cryoablation of cerebral glioma can remove brain tumor totally, less traumatic and less hemorrhagic than conventional approaches, it is safe and convenient to perform. Therefore, it may have an encouraging future in clinical applications, though its long-term efficacies still await further observation due to defects in its manipulation.