Introduction: Stereotactic laser ablation (SLA) is a minimally invasive procedure that is increasingly utilized in neurosurgery. We wished to understand how this procedure is changing the landscape of treatment option for neurosurgical patients.
Methods: Patients undergoing stereotactic laser ablation were prospectively enrolled in the LAANTERN registry. Data from the first 100 enrolled patients are presented here.
Results: Clinical indications for SLA include treatment of high grade gliomas (HGG, 40%), brain metastases (BM, 34%), epilepsy (17%), low grade gliomas (5%), and meningioma/other primary brain tumor (4%). For HGGs, SLA was equally likely used in the up-front (45%) or the recurrent setting (55%, P=0.54). In contrast, SLA was predominantly used as treatment for BMs that failed radiation therapy/radiosurgery (91%), with only 9% of SLAs performed as up-front treatment for newly diagnosed lesions (P<0.001). Of all SLAs performed in brain tumor patients, 42.9% of the procedures were performed in lieu of surgical resection, and 21% were performed because the lesion was not accessible through conventional neurosurgery. Time trend analysis comparing the first and the latter cohort of 50 enrolled patient revealed expanding oncologic applications of SLA beyond treatment of HGG and BM (P=0.02).
Conclusions: HGGs and BMs are the leading indications for SLA in the LAANTERN study. For HGGs, SLA is equally likely used in the up-front or recurrent setting. For BMs, SLA is typically used in the recurrent setting. There is an evolving trend toward expanding oncologic applications of SLA beyond treatment of HGGs and BMs.
Patient Care: By providing a minimally invasive option for selected brain tumors.
Learning Objectives: Understand the evolving use of SLA in neuro-oncology.