Introduction: Laser Interstitial Thermotherapy (LITT) is a minimally invasive procedure for treatment of primary (PT) and metastatic brain tumors (MT). Here we describe multi-institutional results in 144 patients treated with LITT 2015-2016.
Methods: De-identified retrospective data in patients undergoing LITT.
Results: The median age of MT was greater than PT (p < 0.041). The most common indication for LITT for PT was “unresectable tumor,” while “inability to tolerate RT” was most common in MT (p <<0.05). Frontal location was most common in both groups. Deep temporal and callosal tumors were more common in PT. Superficial and brain stem tumors were more common in MT (p < 0.01). Recurrent tumors predominated in the MT group, while nearly equal proportion of primary and recurrent lesions were seen in PT (p<0.05). Both groups had similar baseline median KPS (80-85) while mild pre-op deficits were more common in PT and moderate deficits more common in MT (p<0.02). Lasing time and ICU LOS were longer in PTs (p < 0.005) who were more likely to need rehab (p<0.007). Post-treatment outcome was similar in both groups, though MT more commonly had increased weakness (p <0.04) and pain (p < 0.05). PT patients were more likely to continue steroids and anticonvulsants (p < 0.03), but this was not related to tumor depth or volume. Median survival post-LITT was nearly equal at 21 months, after which patients with PT had slightly longer median survivals through 24 months (41.2% in PT vs 25.6 % in MT).
Conclusions: LITT is effective for both PT and MT. The indications for LITT were different in the two groups, with longer lasing times, ICU LOS, and need for rehab for PT. Conversely, outcome was similar in both groups.
Patient Care: This is a retrospective multi-center study of LITT in primary and metastatic brain tumors. The results justify prospective trials with data collection.
Learning Objectives: By the conclusion of this session, participants should be able to: 1).Describe the importance of LITT; 2.Discuss the indications for LITT; Identify the difference between LITT for PT and MT